Implementation Guide
23.1.0 - R4 APIs

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Resource Profile: AthenaEncounter - Detailed Descriptions

Active as of 2022-03-01

Definitions for the athena-encounter-profile resource profile.

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

0. Encounter
ShortAn interaction during which services are provided to the patient
Must Supportfalse
Alternate NamesVisit
2. Encounter.id
Control0..1
Typeid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
4. Encounter.meta
Control0..1
TypeMeta
Must Supportfalse
6. Encounter.meta.lastUpdated
Control1..1
Typeinstant
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
8. Encounter.meta.profile
Control2..*
Typecanonical
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
SlicingThis element introduces a set of slices on Encounter.meta.profile. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ uri
  • 10. Encounter.meta.profile:us-core-encounter
    Slice Nameus-core-encounter
    Control1..1
    Typecanonical
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Fixed Valuehttp://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter
    12. Encounter.meta.profile:athena-encounter-profile
    Slice Nameathena-encounter-profile
    Control1..1
    Typecanonical
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-encounter-profile
    14. Encounter.meta.security
    Control0..2
    TypeCoding
    Must Supportfalse
    SlicingThis element introduces a set of slices on Encounter.meta.security. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ coding
    • 16. Encounter.meta.security:SENSITIVECHART
      Slice NameSENSITIVECHART
      Control0..1
      TypeCoding
      Must Supportfalse
      18. Encounter.meta.security:CONFABBR
      Slice NameCONFABBR
      Control0..1
      TypeCoding
      Must Supportfalse
      20. Encounter.meta.security:CONFABBR.system
      Control1..1
      Typeuri
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      22. Encounter.meta.security:CONFABBR.code
      Control1..1
      Typecode
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      24. Encounter.meta.tag:CHANGE
      Slice NameCHANGE
      Control1..2
      TypeCoding
      Must Supportfalse
      26. Encounter.extension:SUMMARY
      Slice NameSUMMARY
      Control0..1
      TypeExtension(SUMMARY) (Extension Type: string)
      Must Supportfalse
      28. Encounter.extension:SUMMARY.url
      Control1..1
      Typeuri
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-encounter-extension-SUMMARY
      30. Encounter.extension:SUMMARY.value[x]
      Control1..1
      Typestring
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      32. Encounter.extension:DESCRIPTION
      Slice NameDESCRIPTION
      Control0..1
      TypeExtension(DESCRIPTION) (Extension Type: string)
      Must Supportfalse
      34. Encounter.extension:DESCRIPTION.url
      Control1..1
      Typeuri
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-encounter-extension-DESCRIPTION
      36. Encounter.extension:DESCRIPTION.value[x]
      Control1..1
      Typestring
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      38. Encounter.extension:AUNTHENTICATOR
      Slice NameAUNTHENTICATOR
      Control0..1
      TypeExtension(AUTHENTICATOR) (Extension Type: Reference)
      Must Supportfalse
      40. Encounter.extension:AUNTHENTICATOR.url
      Control1..1
      Typeuri
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-encounter-extension-AUTHENTICATOR
      42. Encounter.extension:AUNTHENTICATOR.value[x]
      Control1..1
      TypeReference(Practitioner)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Must Supportfalse
      44. Encounter.identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Must Supporttrue
      46. Encounter.status
      Control1..1
      Typecode
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      48. Encounter.class
      Control1..1
      TypeCoding
      Must Supporttrue
      50. Encounter.class.system
      Control1..1
      Typeuri
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Fixed Valuehttp://terminology.hl7.org/CodeSystem/v3-ActCode
      52. Encounter.class.code
      Control1..1
      Typecode
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Fixed ValueAMB
      54. Encounter.class.display
      Control1..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Fixed Valueambulatory
      56. Encounter.type
      Comments

      Since there are many ways to further classify encounters, this element is 0..*.

      Control0..*
      TypeCodeableConcept
      Must Supporttrue
      58. Encounter.type.coding
      Control0..2
      TypeCoding
      Must Supportfalse
      SlicingThis element introduces a set of slices on Encounter.type.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ system
      • 60. Encounter.type.coding:SNOMEDCODE
        Slice NameSNOMEDCODE
        Control0..1
        TypeCoding
        Must Supportfalse
        62. Encounter.type.coding:DOCTYPE
        Slice NameDOCTYPE
        Control0..1
        TypeCoding
        Must Supportfalse
        64. Encounter.type.coding:DOCTYPE.system
        Control0..1
        Typeuri
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/athenaFlex/codesystem/DOCUMENTTYPE
        66. Encounter.type.coding:DOCTYPE.code
        Control0..1
        Typecode
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        68. Encounter.type.coding:DOCTYPE.display
        Control0..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        70. Encounter.priority
        Control0..1
        TypeCodeableConcept
        Must Supportfalse
        72. Encounter.subject
        Comments

        While the encounter is always about the patient, the patient may not actually be known in all contexts of use.

        Control1..1
        TypeReference(Patient)
        Must Supporttrue
        Alternate Namespatient
        74. Encounter.participant
        Control0..*
        TypeBackboneElement
        Must Supporttrue
        76. Encounter.appointment
        Control0..1
        TypeReference(Appointment)
        Must Supportfalse
        78. Encounter.period
        Comments

        If not (yet) known, the end of the Period may be omitted.

        Control0..1
        TypePeriod
        Must Supporttrue
        80. Encounter.reasonCode
        Comments

        For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

        Control0..*
        TypeCodeableConcept
        Must Supporttrue
        Alternate NamesIndication, Admission diagnosis
        82. Encounter.reasonReference
        Comments

        For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

        Control0..*
        TypeReference(Condition)
        Must Supportfalse
        84. Encounter.hospitalization
        Control0..1
        Must Supportfalse
        86. Encounter.hospitalization.dischargeDisposition
        Control0..1
        TypeCodeableConcept
        Must Supportfalse
        88. Encounter.location
        Comments

        Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".

        Control0..*
        Must Supporttrue
        90. Encounter.location.location
        Control1..1
        TypeReference(Location)
        Must Supporttrue

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

        0. Encounter
        Definition

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

        ShortAn interaction during which services are provided to the patient
        Control0..*
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Alternate NamesVisit
        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
        dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
        dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
        dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
        dom-6: A resource should have narrative for robust management (text.`div`.exists())
        2. Encounter.id
        Definition

        The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

        ShortLogical id of this artifact
        Comments

        The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

        Control0..1
        Typeidstring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        4. Encounter.meta
        Definition

        The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

        ShortMetadata about the resource
        Control0..1
        TypeMeta
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        6. Encounter.meta.lastUpdated
        Definition

        When the resource last changed - e.g. when the version changed.

        ShortWhen the resource version last changed
        Comments

        This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

        Control10..1
        Typeinstant
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        8. Encounter.meta.profile
        Definition

        A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

        ShortProfiles this resource claims to conform to
        Comments

        It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

        Control20..*
        Typecanonical(StructureDefinition)
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Encounter.meta.profile. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ uri
        • 10. Encounter.meta.profile:us-core-encounter
          Slice Nameus-core-encounter
          Definition

          A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

          ShortProfiles this resource claims to conform to
          Comments

          It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

          Control10..1*
          Typecanonical(StructureDefinition)
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Fixed Valuehttp://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. Encounter.meta.profile:athena-encounter-profile
          Slice Nameathena-encounter-profile
          Definition

          A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

          ShortProfiles this resource claims to conform to
          Comments

          It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

          Control10..1*
          Typecanonical(StructureDefinition)
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-encounter-profile
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          14. Encounter.meta.security
          Definition

          Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

          ShortSecurity Labels applied to this resource
          Comments

          The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

          Control0..2*
          BindingUnless not suitable, these codes SHALL be taken from All Security Labelshttp://hl7.org/fhir/ValueSet/security-labels
          (extensible to http://hl7.org/fhir/ValueSet/security-labels)

          Security Labels from the Healthcare Privacy and Security Classification System.

          TypeCoding
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Encounter.meta.security. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ coding
          • 16. Encounter.meta.security:SENSITIVECHART
            Slice NameSENSITIVECHART
            Definition

            Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

            ShortSecurity Labels applied to this resource
            Comments

            The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

            Control0..1*
            BindingUnless not suitable, these codes SHALL be taken from All Security Labelshttp://hl7.org/fhir/ValueSet/security-labels
            (extensible to http://hl7.org/fhir/ValueSet/security-labels)

            Security Labels from the Healthcare Privacy and Security Classification System.

            TypeCoding
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            18. Encounter.meta.security:CONFABBR
            Slice NameCONFABBR
            Definition

            Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

            ShortSecurity Labels applied to this resource
            Comments

            The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

            Control0..1*
            BindingUnless not suitable, these codes SHALL be taken from All Security Labelshttp://hl7.org/fhir/ValueSet/security-labels
            (extensible to http://hl7.org/fhir/ValueSet/security-labels)

            Security Labels from the Healthcare Privacy and Security Classification System.

            TypeCoding
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            20. Encounter.meta.security:CONFABBR.system
            Definition

            The identification of the code system that defines the meaning of the symbol in the code.

            ShortIdentity of the terminology system
            Comments

            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

            Control10..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summarytrue
            Requirements

            Need to be unambiguous about the source of the definition of the symbol.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            22. Encounter.meta.security:CONFABBR.code
            Definition

            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

            ShortSymbol in syntax defined by the system
            Control10..1
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summarytrue
            Requirements

            Need to refer to a particular code in the system.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            24. Encounter.meta.tag:CHANGE
            Slice NameCHANGE
            Definition

            Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

            ShortTags applied to this resource
            Comments

            The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

            Control10..2*
            BindingFor example codes, see CommonTagshttp://hl7.org/fhir/ValueSet/common-tags
            (example to http://hl7.org/fhir/ValueSet/common-tags)

            Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

            TypeCoding
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            26. Encounter.implicitRules
            Definition

            A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

            ShortA set of rules under which this content was created
            Comments

            Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

            Control0..1
            Typeuri
            Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. Encounter.extension:SUMMARY
            Slice NameSUMMARY
            Definition

            An Extension

            ShortExtension
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(SUMMARY) (Extension Type: string)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            30. Encounter.extension:SUMMARY.url
            Definition

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

            Shortidentifies the meaning of the extension
            Comments

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

            Control1..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-encounter-extension-SUMMARY
            32. Encounter.extension:SUMMARY.value[x]
            Definition

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

            ShortValue of extension
            Control10..1
            Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            34. Encounter.extension:DESCRIPTION
            Slice NameDESCRIPTION
            Definition

            An Extension

            ShortExtension
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(DESCRIPTION) (Extension Type: string)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            36. Encounter.extension:DESCRIPTION.url
            Definition

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

            Shortidentifies the meaning of the extension
            Comments

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

            Control1..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-encounter-extension-DESCRIPTION
            38. Encounter.extension:DESCRIPTION.value[x]
            Definition

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

            ShortValue of extension
            Control10..1
            Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            40. Encounter.extension:AUNTHENTICATOR
            Slice NameAUNTHENTICATOR
            Definition

            An Extension

            ShortExtension
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(AUTHENTICATOR) (Extension Type: Reference)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            42. Encounter.extension:AUNTHENTICATOR.url
            Definition

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

            Shortidentifies the meaning of the extension
            Comments

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

            Control1..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-encounter-extension-AUTHENTICATOR
            44. Encounter.extension:AUNTHENTICATOR.value[x]
            Definition

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

            ShortValue of extension
            Control10..1
            TypeReference(Practitioner), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            46. Encounter.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

            ShortExtensions that cannot be ignored
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Summaryfalse
            Requirements

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

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

            Identifier(s) by which this encounter is known.

            ShortIdentifier(s) by which this encounter is known
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            50. Encounter.status
            Definition

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

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

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

            Control1..1
            BindingThe codes SHALL be taken from EncounterStatushttp://hl7.org/fhir/ValueSet/encounter-status|4.0.1
            (required to http://hl7.org/fhir/ValueSet/encounter-status|4.0.1)

            Current state of the encounter.

            Typecode
            Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. Encounter.class
            Definition

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

            ShortClassification of patient encounter
            Control1..1
            BindingUnless not suitable, these codes SHALL be taken from ActEncounterCodehttp://terminology.hl7.org/ValueSet/v3-ActEncounterCode
            (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)

            Classification of the encounter.

            TypeCoding
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            54. Encounter.class.system
            Definition

            The identification of the code system that defines the meaning of the symbol in the code.

            ShortIdentity of the terminology system
            Comments

            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

            Control10..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summarytrue
            Requirements

            Need to be unambiguous about the source of the definition of the symbol.

            Fixed Valuehttp://terminology.hl7.org/CodeSystem/v3-ActCode
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. Encounter.class.code
            Definition

            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

            ShortSymbol in syntax defined by the system
            Control10..1
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summarytrue
            Requirements

            Need to refer to a particular code in the system.

            Fixed ValueAMB
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. Encounter.class.display
            Definition

            A representation of the meaning of the code in the system, following the rules of the system.

            ShortRepresentation defined by the system
            Control10..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summarytrue
            Requirements

            Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

            Fixed Valueambulatory
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. Encounter.type
            Definition

            Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).

            ShortSpecific type of encounter
            Comments

            Since there are many ways to further classify encounters, this element is 0..*.

            Control0..*
            BindingFor example codes, see EncounterTypehttp://hl7.org/fhir/ValueSet/encounter-type
            (example to http://hl7.org/fhir/ValueSet/encounter-type)

            The type of encounter.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. Encounter.type.coding
            Definition

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Control0..2*
            TypeCoding
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Requirements

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

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on Encounter.type.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ system
            • 64. Encounter.type.coding:SNOMEDCODE
              Slice NameSNOMEDCODE
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control0..1*
              TypeCoding
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Requirements

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

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              66. Encounter.type.coding:DOCTYPE
              Slice NameDOCTYPE
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control0..1*
              TypeCoding
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Requirements

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

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              68. Encounter.type.coding:DOCTYPE.system
              Definition

              The identification of the code system that defines the meaning of the symbol in the code.

              ShortIdentity of the terminology system
              Comments

              The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

              Control0..1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supportfalse
              Summarytrue
              Requirements

              Need to be unambiguous about the source of the definition of the symbol.

              Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/athenaFlex/codesystem/DOCUMENTTYPE
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              70. Encounter.type.coding:DOCTYPE.code
              Definition

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

              ShortSymbol in syntax defined by the system
              Control0..1
              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supportfalse
              Summarytrue
              Requirements

              Need to refer to a particular code in the system.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              72. Encounter.type.coding:DOCTYPE.display
              Definition

              A representation of the meaning of the code in the system, following the rules of the system.

              ShortRepresentation defined by the system
              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supportfalse
              Summarytrue
              Requirements

              Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

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

              Indicates the urgency of the encounter.

              ShortIndicates the urgency of the encounter
              Control0..1
              BindingFor example codes, see ActPriorityhttp://terminology.hl7.org/ValueSet/v3-ActPriority
              (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)

              Indicates the urgency of the encounter.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              76. Encounter.subject
              Definition

              The patient or group present at the encounter.

              ShortThe patient or group present at the encounter
              Comments

              While the encounter is always about the patient, the patient may not actually be known in all contexts of use.


              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).

              Control10..1
              TypeReference(Patient, Group)
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Alternate Namespatient
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              78. Encounter.participant
              Definition

              The list of people responsible for providing the service.

              ShortList of participants involved in the encounter
              Control0..*
              TypeBackboneElement
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              80. Encounter.participant.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

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

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

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

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

              The appointment that scheduled this encounter.

              ShortThe appointment that scheduled this encounter
              Control0..1*
              TypeReference(Appointment)
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              84. Encounter.period
              Definition

              The start and end time of the encounter.

              ShortThe start and end time of the encounter
              Comments

              If not (yet) known, the end of the Period may be omitted.

              Control0..1
              TypePeriod
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              86. Encounter.reasonCode
              Definition

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

              ShortCoded reason the encounter takes place
              Comments

              For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

              Control0..*
              BindingThe codes SHOULD be taken from EncounterReasonCodeshttp://hl7.org/fhir/ValueSet/encounter-reason
              (preferred to http://hl7.org/fhir/ValueSet/encounter-reason)

              Reason why the encounter takes place.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Alternate NamesIndication, Admission diagnosis
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              88. Encounter.reasonReference
              Definition

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

              ShortReason the encounter takes place (reference)
              Comments

              For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

              Control0..*
              TypeReference(Condition, Procedure, Observation, ImmunizationRecommendation)
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Alternate NamesIndication, Admission diagnosis
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              90. Encounter.hospitalization
              Definition

              Details about the admission to a healthcare service.

              ShortDetails about the admission to a healthcare service
              Comments

              An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.

              The duration recorded in the period of this encounter covers the entire scope of this hospitalization record.

              Control0..1
              TypeBackboneElement
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              92. Encounter.hospitalization.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

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

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

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

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

              Category or kind of location after discharge.

              ShortCategory or kind of location after discharge
              Control0..1
              BindingFor example codes, see DischargeDispositionhttp://hl7.org/fhir/ValueSet/encounter-discharge-disposition
              (example to http://hl7.org/fhir/ValueSet/encounter-discharge-disposition)

              Discharge Disposition.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              96. Encounter.location
              Definition

              List of locations where the patient has been during this encounter.

              ShortList of locations where the patient has been
              Comments

              Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".

              Control0..*
              TypeBackboneElement
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              98. Encounter.location.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

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

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

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

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

              The location where the encounter takes place.

              ShortLocation the encounter takes place
              Control1..1
              TypeReference(Location)
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

              0. Encounter
              Definition

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

              ShortAn interaction during which services are provided to the patient
              Control0..*
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Alternate NamesVisit
              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
              dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
              dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
              dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
              dom-6: A resource should have narrative for robust management (text.`div`.exists())
              2. Encounter.id
              Definition

              The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

              ShortLogical id of this artifact
              Comments

              The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

              Control0..1
              Typeid
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              4. Encounter.meta
              Definition

              The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

              ShortMetadata about the resource
              Control0..1
              TypeMeta
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              6. Encounter.meta.id
              Definition

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

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              8. Encounter.meta.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

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

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Encounter.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 10. Encounter.meta.versionId
                Definition

                The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

                ShortVersion specific identifier
                Comments

                The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

                Control0..1
                Typeid
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                12. Encounter.meta.lastUpdated
                Definition

                When the resource last changed - e.g. when the version changed.

                ShortWhen the resource version last changed
                Comments

                This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

                Control1..1
                Typeinstant
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                14. Encounter.meta.source
                Definition

                A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

                ShortIdentifies where the resource comes from
                Comments

                In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

                This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

                Control0..1
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                16. Encounter.meta.profile
                Definition

                A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                ShortProfiles this resource claims to conform to
                Comments

                It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                Control2..*
                Typecanonical
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on Encounter.meta.profile. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ uri
                • 18. Encounter.meta.profile:us-core-encounter
                  Slice Nameus-core-encounter
                  Definition

                  A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                  ShortProfiles this resource claims to conform to
                  Comments

                  It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                  Control1..1
                  Typecanonical
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supportfalse
                  Summarytrue
                  Fixed Valuehttp://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  20. Encounter.meta.profile:athena-encounter-profile
                  Slice Nameathena-encounter-profile
                  Definition

                  A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                  ShortProfiles this resource claims to conform to
                  Comments

                  It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                  Control1..1
                  Typecanonical
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supportfalse
                  Summarytrue
                  Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-encounter-profile
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  22. Encounter.meta.security
                  Definition

                  Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                  ShortSecurity Labels applied to this resource
                  Comments

                  The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                  Control0..2
                  BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                  (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                  Security Labels from the Healthcare Privacy and Security Classification System.

                  TypeCoding
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on Encounter.meta.security. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ coding
                  • 24. Encounter.meta.security:SENSITIVECHART
                    Slice NameSENSITIVECHART
                    Definition

                    Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                    ShortSecurity Labels applied to this resource
                    Comments

                    The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                    (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                    Security Labels from the Healthcare Privacy and Security Classification System.

                    TypeCoding
                    Is Modifierfalse
                    Must Supportfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    26. Encounter.meta.security:CONFABBR
                    Slice NameCONFABBR
                    Definition

                    Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                    ShortSecurity Labels applied to this resource
                    Comments

                    The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                    (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                    Security Labels from the Healthcare Privacy and Security Classification System.

                    TypeCoding
                    Is Modifierfalse
                    Must Supportfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    28. Encounter.meta.security:CONFABBR.id
                    Definition

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

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    30. Encounter.meta.security:CONFABBR.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

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

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on Encounter.meta.security.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 32. Encounter.meta.security:CONFABBR.system
                      Definition

                      The identification of the code system that defines the meaning of the symbol in the code.

                      ShortIdentity of the terminology system
                      Comments

                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                      Control1..1
                      Typeuri
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supportfalse
                      Summarytrue
                      Requirements

                      Need to be unambiguous about the source of the definition of the symbol.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      34. Encounter.meta.security:CONFABBR.version
                      Definition

                      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                      ShortVersion of the system - if relevant
                      Comments

                      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                      NoteThis is a business version Id, not a resource version Id (see discussion)
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      36. Encounter.meta.security:CONFABBR.code
                      Definition

                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                      ShortSymbol in syntax defined by the system
                      Control1..1
                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supportfalse
                      Summarytrue
                      Requirements

                      Need to refer to a particular code in the system.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      38. Encounter.meta.security:CONFABBR.display
                      Definition

                      A representation of the meaning of the code in the system, following the rules of the system.

                      ShortRepresentation defined by the system
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      40. Encounter.meta.security:CONFABBR.userSelected
                      Definition

                      Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                      ShortIf this coding was chosen directly by the user
                      Comments

                      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                      Control0..1
                      Typeboolean
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      42. Encounter.meta.tag:CHANGE
                      Slice NameCHANGE
                      Definition

                      Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

                      ShortTags applied to this resource
                      Comments

                      The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

                      Control1..2
                      BindingFor example codes, see CommonTags
                      (example to http://hl7.org/fhir/ValueSet/common-tags)

                      Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

                      TypeCoding
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      44. Encounter.implicitRules
                      Definition

                      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                      ShortA set of rules under which this content was created
                      Comments

                      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                      Control0..1
                      Typeuri
                      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      46. Encounter.language
                      Definition

                      The base language in which the resource is written.

                      ShortLanguage of the resource content
                      Comments

                      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                      Control0..1
                      BindingThe codes SHOULD be taken from CommonLanguages
                      (preferred to http://hl7.org/fhir/ValueSet/languages)

                      A human language.

                      Additional BindingsPurpose
                      AllLanguagesMax Binding
                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      48. Encounter.text
                      Definition

                      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                      ShortText summary of the resource, for human interpretation
                      Comments

                      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                      Control0..1
                      TypeNarrative
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesnarrative, html, xhtml, display
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      50. Encounter.contained
                      Definition

                      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                      ShortContained, inline Resources
                      Comments

                      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                      Control0..*
                      TypeResource
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesinline resources, anonymous resources, contained resources
                      52. Encounter.extension
                      Definition

                      An Extension

                      ShortExtension
                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on Encounter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 54. Encounter.extension:SUMMARY
                        Slice NameSUMMARY
                        Definition

                        An Extension

                        ShortExtension
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeExtension(SUMMARY) (Extension Type: string)
                        Is Modifierfalse
                        Must Supportfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        56. Encounter.extension:SUMMARY.id
                        Definition

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

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        58. Encounter.extension:SUMMARY.extension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                        ShortAdditional content defined by implementations
                        Comments

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

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on Encounter.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 60. Encounter.extension:SUMMARY.url
                          Definition

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

                          Shortidentifies the meaning of the extension
                          Comments

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

                          Control1..1
                          Typeuri
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-encounter-extension-SUMMARY
                          62. Encounter.extension:SUMMARY.value[x]
                          Definition

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

                          ShortValue of extension
                          Control1..1
                          Typestring
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          64. Encounter.extension:DESCRIPTION
                          Slice NameDESCRIPTION
                          Definition

                          An Extension

                          ShortExtension
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(DESCRIPTION) (Extension Type: string)
                          Is Modifierfalse
                          Must Supportfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          66. Encounter.extension:DESCRIPTION.id
                          Definition

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

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          68. Encounter.extension:DESCRIPTION.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

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

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on Encounter.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 70. Encounter.extension:DESCRIPTION.url
                            Definition

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

                            Shortidentifies the meaning of the extension
                            Comments

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

                            Control1..1
                            Typeuri
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supportfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-encounter-extension-DESCRIPTION
                            72. Encounter.extension:DESCRIPTION.value[x]
                            Definition

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

                            ShortValue of extension
                            Control1..1
                            Typestring
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supportfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            74. Encounter.extension:AUNTHENTICATOR
                            Slice NameAUNTHENTICATOR
                            Definition

                            An Extension

                            ShortExtension
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(AUTHENTICATOR) (Extension Type: Reference)
                            Is Modifierfalse
                            Must Supportfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            76. Encounter.extension:AUNTHENTICATOR.id
                            Definition

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

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

                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            Comments

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

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on Encounter.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 80. Encounter.extension:AUNTHENTICATOR.url
                              Definition

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

                              Shortidentifies the meaning of the extension
                              Comments

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

                              Control1..1
                              Typeuri
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supportfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-encounter-extension-AUTHENTICATOR
                              82. Encounter.extension:AUNTHENTICATOR.value[x]
                              Definition

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

                              ShortValue of extension
                              Control1..1
                              TypeReference(Practitioner)
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              84. Encounter.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                              ShortExtensions that cannot be ignored
                              Comments

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

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                              Summaryfalse
                              Requirements

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

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

                              Identifier(s) by which this encounter is known.

                              ShortIdentifier(s) by which this encounter is known
                              NoteThis is a business identifier, not a resource identifier (see discussion)
                              Control0..*
                              TypeIdentifier
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              88. Encounter.status
                              Definition

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

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

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

                              Control1..1
                              BindingThe codes SHALL be taken from EncounterStatus
                              (required to http://hl7.org/fhir/ValueSet/encounter-status|4.0.1)

                              Current state of the encounter.

                              Typecode
                              Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              90. Encounter.statusHistory
                              Definition

                              The status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them.

                              ShortList of past encounter statuses
                              Comments

                              The current status is always found in the current version of the resource, not the status history.

                              Control0..*
                              TypeBackboneElement
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              92. Encounter.statusHistory.id
                              Definition

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

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              94. Encounter.statusHistory.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

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

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              96. Encounter.statusHistory.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

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

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                              Summarytrue
                              Requirements

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

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

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

                              Shortplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
                              Control1..1
                              BindingThe codes SHALL be taken from EncounterStatus
                              (required to http://hl7.org/fhir/ValueSet/encounter-status|4.0.1)

                              Current state of the encounter.

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

                              The time that the episode was in the specified status.

                              ShortThe time that the episode was in the specified status
                              Control1..1
                              TypePeriod
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              102. Encounter.class
                              Definition

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

                              ShortClassification of patient encounter
                              Control1..1
                              BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode
                              (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)

                              Classification of the encounter.

                              TypeCoding
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              104. Encounter.class.id
                              Definition

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

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              106. Encounter.class.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

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

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on Encounter.class.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 108. Encounter.class.system
                                Definition

                                The identification of the code system that defines the meaning of the symbol in the code.

                                ShortIdentity of the terminology system
                                Comments

                                The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                Control1..1
                                Typeuri
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supportfalse
                                Summarytrue
                                Requirements

                                Need to be unambiguous about the source of the definition of the symbol.

                                Fixed Valuehttp://terminology.hl7.org/CodeSystem/v3-ActCode
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                110. Encounter.class.version
                                Definition

                                The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                ShortVersion of the system - if relevant
                                Comments

                                Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                NoteThis is a business version Id, not a resource version Id (see discussion)
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                112. Encounter.class.code
                                Definition

                                A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                ShortSymbol in syntax defined by the system
                                Control1..1
                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supportfalse
                                Summarytrue
                                Requirements

                                Need to refer to a particular code in the system.

                                Fixed ValueAMB
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                114. Encounter.class.display
                                Definition

                                A representation of the meaning of the code in the system, following the rules of the system.

                                ShortRepresentation defined by the system
                                Control1..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supportfalse
                                Summarytrue
                                Requirements

                                Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                Fixed Valueambulatory
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                116. Encounter.class.userSelected
                                Definition

                                Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                ShortIf this coding was chosen directly by the user
                                Comments

                                Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                Control0..1
                                Typeboolean
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                                The class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transitions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kind of discharge from emergency to inpatient.

                                ShortList of past encounter classes
                                Control0..*
                                TypeBackboneElement
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                120. Encounter.classHistory.id
                                Definition

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                122. Encounter.classHistory.extension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                ShortAdditional content defined by implementations
                                Comments

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

                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                124. Encounter.classHistory.modifierExtension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

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

                                Control0..*
                                TypeExtension
                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                Summarytrue
                                Requirements

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

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

                                inpatient | outpatient | ambulatory | emergency +.

                                Shortinpatient | outpatient | ambulatory | emergency +
                                Control1..1
                                BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode
                                (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)

                                Classification of the encounter.

                                TypeCoding
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                128. Encounter.classHistory.period
                                Definition

                                The time that the episode was in the specified class.

                                ShortThe time that the episode was in the specified class
                                Control1..1
                                TypePeriod
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                130. Encounter.type
                                Definition

                                Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).

                                ShortSpecific type of encounter
                                Comments

                                Since there are many ways to further classify encounters, this element is 0..*.

                                Control0..*
                                BindingFor example codes, see EncounterType
                                (example to http://hl7.org/fhir/ValueSet/encounter-type)

                                The type of encounter.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                132. Encounter.type.id
                                Definition

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                134. Encounter.type.extension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                ShortAdditional content defined by implementations
                                Comments

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

                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Encounter.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 136. Encounter.type.coding
                                  Definition

                                  A reference to a code defined by a terminology system.

                                  ShortCode defined by a terminology system
                                  Comments

                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                  Control0..2
                                  TypeCoding
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summarytrue
                                  Requirements

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

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  SlicingThis element introduces a set of slices on Encounter.type.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ system
                                  • 138. Encounter.type.coding:SNOMEDCODE
                                    Slice NameSNOMEDCODE
                                    Definition

                                    A reference to a code defined by a terminology system.

                                    ShortCode defined by a terminology system
                                    Comments

                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                    Control0..1
                                    TypeCoding
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summarytrue
                                    Requirements

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

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    140. Encounter.type.coding:DOCTYPE
                                    Slice NameDOCTYPE
                                    Definition

                                    A reference to a code defined by a terminology system.

                                    ShortCode defined by a terminology system
                                    Comments

                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                    Control0..1
                                    TypeCoding
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summarytrue
                                    Requirements

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

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    142. Encounter.type.coding:DOCTYPE.id
                                    Definition

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

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    144. Encounter.type.coding:DOCTYPE.extension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                    ShortAdditional content defined by implementations
                                    Comments

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

                                    Control0..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on Encounter.type.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 146. Encounter.type.coding:DOCTYPE.system
                                      Definition

                                      The identification of the code system that defines the meaning of the symbol in the code.

                                      ShortIdentity of the terminology system
                                      Comments

                                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                      Control0..1
                                      Typeuri
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summarytrue
                                      Requirements

                                      Need to be unambiguous about the source of the definition of the symbol.

                                      Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/athenaFlex/codesystem/DOCUMENTTYPE
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      148. Encounter.type.coding:DOCTYPE.version
                                      Definition

                                      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                      ShortVersion of the system - if relevant
                                      Comments

                                      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                      NoteThis is a business version Id, not a resource version Id (see discussion)
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      150. Encounter.type.coding:DOCTYPE.code
                                      Definition

                                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                      ShortSymbol in syntax defined by the system
                                      Control0..1
                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summarytrue
                                      Requirements

                                      Need to refer to a particular code in the system.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      152. Encounter.type.coding:DOCTYPE.display
                                      Definition

                                      A representation of the meaning of the code in the system, following the rules of the system.

                                      ShortRepresentation defined by the system
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summarytrue
                                      Requirements

                                      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      154. Encounter.type.coding:DOCTYPE.userSelected
                                      Definition

                                      Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                      ShortIf this coding was chosen directly by the user
                                      Comments

                                      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                      Control0..1
                                      Typeboolean
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                      ShortPlain text representation of the concept
                                      Comments

                                      Very often the text is the same as a displayName of one of the codings.

                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

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

                                      ShortSpecific type of service
                                      Control0..1
                                      BindingFor example codes, see ServiceType
                                      (example to http://hl7.org/fhir/ValueSet/service-type)

                                      Broad categorization of the service that is to be provided.

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

                                      Indicates the urgency of the encounter.

                                      ShortIndicates the urgency of the encounter
                                      Control0..1
                                      BindingFor example codes, see ActPriority
                                      (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)

                                      Indicates the urgency of the encounter.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      162. Encounter.subject
                                      Definition

                                      The patient or group present at the encounter.

                                      ShortThe patient or group present at the encounter
                                      Comments

                                      While the encounter is always about the patient, the patient may not actually be known in all contexts of use.

                                      Control1..1
                                      TypeReference(Patient)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Alternate Namespatient
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      164. Encounter.episodeOfCare
                                      Definition

                                      Where a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years).

                                      ShortEpisode(s) of care that this encounter should be recorded against
                                      Control0..*
                                      TypeReference(EpisodeOfCare)
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      166. Encounter.basedOn
                                      Definition

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

                                      ShortThe ServiceRequest that initiated this encounter
                                      Control0..*
                                      TypeReference(ServiceRequest)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate NamesincomingReferral
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      168. Encounter.participant
                                      Definition

                                      The list of people responsible for providing the service.

                                      ShortList of participants involved in the encounter
                                      Control0..*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      170. Encounter.participant.id
                                      Definition

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

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

                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      Comments

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

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      174. Encounter.participant.modifierExtension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

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

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

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

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

                                      Role of participant in encounter.

                                      ShortRole of participant in encounter
                                      Comments

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

                                      Control0..*
                                      BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                                      (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                                      Role of participant in encounter.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      178. Encounter.participant.period
                                      Definition

                                      The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.

                                      ShortPeriod of time during the encounter that the participant participated
                                      Control0..1
                                      TypePeriod
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      180. Encounter.participant.individual
                                      Definition

                                      Persons involved in the encounter other than the patient.

                                      ShortPersons involved in the encounter other than the patient
                                      Control0..1
                                      TypeReference(Practitioner, PractitionerRole, RelatedPerson)
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      182. Encounter.appointment
                                      Definition

                                      The appointment that scheduled this encounter.

                                      ShortThe appointment that scheduled this encounter
                                      Control0..1
                                      TypeReference(Appointment)
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      184. Encounter.period
                                      Definition

                                      The start and end time of the encounter.

                                      ShortThe start and end time of the encounter
                                      Comments

                                      If not (yet) known, the end of the Period may be omitted.

                                      Control0..1
                                      TypePeriod
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      186. Encounter.length
                                      Definition

                                      Quantity of time the encounter lasted. This excludes the time during leaves of absence.

                                      ShortQuantity of time the encounter lasted (less time absent)
                                      Comments

                                      May differ from the time the Encounter.period lasted because of leave of absence.

                                      Control0..1
                                      TypeDuration
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      188. Encounter.reasonCode
                                      Definition

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

                                      ShortCoded reason the encounter takes place
                                      Comments

                                      For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

                                      Control0..*
                                      BindingThe codes SHOULD be taken from EncounterReasonCodes
                                      (preferred to http://hl7.org/fhir/ValueSet/encounter-reason)

                                      Reason why the encounter takes place.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Alternate NamesIndication, Admission diagnosis
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      190. Encounter.reasonReference
                                      Definition

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

                                      ShortReason the encounter takes place (reference)
                                      Comments

                                      For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

                                      Control0..*
                                      TypeReference(Condition)
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summarytrue
                                      Alternate NamesIndication, Admission diagnosis
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      192. Encounter.diagnosis
                                      Definition

                                      The list of diagnosis relevant to this encounter.

                                      ShortThe list of diagnosis relevant to this encounter
                                      Control0..*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      194. Encounter.diagnosis.id
                                      Definition

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

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

                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      Comments

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

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      198. Encounter.diagnosis.modifierExtension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

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

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

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

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

                                      Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.

                                      ShortThe diagnosis or procedure relevant to the encounter
                                      Comments

                                      For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

                                      Control1..1
                                      TypeReference(Condition, Procedure)
                                      Is Modifierfalse
                                      Summarytrue
                                      Alternate NamesAdmission diagnosis, discharge diagnosis, indication
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      202. Encounter.diagnosis.use
                                      Definition

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

                                      ShortRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
                                      Control0..1
                                      BindingThe codes SHOULD be taken from DiagnosisRole
                                      (preferred to http://hl7.org/fhir/ValueSet/diagnosis-role)

                                      The type of diagnosis this condition represents.

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

                                      Ranking of the diagnosis (for each role type).

                                      ShortRanking of the diagnosis (for each role type)
                                      Control0..1
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      206. Encounter.account
                                      Definition

                                      The set of accounts that may be used for billing for this Encounter.

                                      ShortThe set of accounts that may be used for billing for this Encounter
                                      Comments

                                      The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.

                                      Control0..*
                                      TypeReference(Account)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      208. Encounter.hospitalization
                                      Definition

                                      Details about the admission to a healthcare service.

                                      ShortDetails about the admission to a healthcare service
                                      Comments

                                      An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.

                                      The duration recorded in the period of this encounter covers the entire scope of this hospitalization record.

                                      Control0..1
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      210. Encounter.hospitalization.id
                                      Definition

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

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

                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      Comments

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

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      214. Encounter.hospitalization.modifierExtension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

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

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

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

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

                                      Pre-admission identifier.

                                      ShortPre-admission identifier
                                      Control0..1
                                      TypeIdentifier
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      218. Encounter.hospitalization.origin
                                      Definition

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

                                      ShortThe location/organization from which the patient came before admission
                                      Control0..1
                                      TypeReference(Location, Organization)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      220. Encounter.hospitalization.admitSource
                                      Definition

                                      From where patient was admitted (physician referral, transfer).

                                      ShortFrom where patient was admitted (physician referral, transfer)
                                      Control0..1
                                      BindingThe codes SHOULD be taken from AdmitSource
                                      (preferred to http://hl7.org/fhir/ValueSet/encounter-admit-source)

                                      From where the patient was admitted.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      222. Encounter.hospitalization.reAdmission
                                      Definition

                                      Whether this hospitalization is a readmission and why if known.

                                      ShortThe type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
                                      Control0..1
                                      BindingFor example codes, see hl7VS-re-admissionIndicator
                                      (example to http://terminology.hl7.org/ValueSet/v2-0092)

                                      The reason for re-admission of this hospitalization encounter.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      224. Encounter.hospitalization.dietPreference
                                      Definition

                                      Diet preferences reported by the patient.

                                      ShortDiet preferences reported by the patient
                                      Comments

                                      For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).

                                      Control0..*
                                      BindingFor example codes, see Diet
                                      (example to http://hl7.org/fhir/ValueSet/encounter-diet)

                                      Medical, cultural or ethical food preferences to help with catering requirements.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter.

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

                                      Special courtesies (VIP, board member).

                                      ShortSpecial courtesies (VIP, board member)
                                      Control0..*
                                      BindingThe codes SHOULD be taken from SpecialCourtesy
                                      (preferred to http://hl7.org/fhir/ValueSet/encounter-special-courtesy)

                                      Special courtesies.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      228. Encounter.hospitalization.specialArrangement
                                      Definition

                                      Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.

                                      ShortWheelchair, translator, stretcher, etc.
                                      Control0..*
                                      BindingThe codes SHOULD be taken from SpecialArrangements
                                      (preferred to http://hl7.org/fhir/ValueSet/encounter-special-arrangements)

                                      Special arrangements.

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

                                      Location/organization to which the patient is discharged.

                                      ShortLocation/organization to which the patient is discharged
                                      Control0..1
                                      TypeReference(Location, Organization)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      232. Encounter.hospitalization.dischargeDisposition
                                      Definition

                                      Category or kind of location after discharge.

                                      ShortCategory or kind of location after discharge
                                      Control0..1
                                      BindingFor example codes, see DischargeDisposition
                                      (example to http://hl7.org/fhir/ValueSet/encounter-discharge-disposition)

                                      Discharge Disposition.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      234. Encounter.location
                                      Definition

                                      List of locations where the patient has been during this encounter.

                                      ShortList of locations where the patient has been
                                      Comments

                                      Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".

                                      Control0..*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      236. Encounter.location.id
                                      Definition

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

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

                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      Comments

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

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      240. Encounter.location.modifierExtension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

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

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

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

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

                                      The location where the encounter takes place.

                                      ShortLocation the encounter takes place
                                      Control1..1
                                      TypeReference(Location)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      244. Encounter.location.status
                                      Definition

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

                                      Shortplanned | active | reserved | completed
                                      Comments

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

                                      Control0..1
                                      BindingThe codes SHALL be taken from EncounterLocationStatus
                                      (required to http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1)

                                      The status of the location.

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

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

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

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

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

                                      Control0..1
                                      BindingFor example codes, see LocationType
                                      (example to http://hl7.org/fhir/ValueSet/location-physical-type)

                                      Physical form of the location.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      248. Encounter.location.period
                                      Definition

                                      Time period during which the patient was present at the location.

                                      ShortTime period during which the patient was present at the location
                                      Control0..1
                                      TypePeriod
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      250. Encounter.serviceProvider
                                      Definition

                                      The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy.

                                      ShortThe organization (facility) responsible for this encounter
                                      Control0..1
                                      TypeReference(Organization)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      252. Encounter.partOf
                                      Definition

                                      Another Encounter of which this encounter is a part of (administratively or in time).

                                      ShortAnother Encounter this encounter is part of
                                      Comments

                                      This is also used for associating a child's encounter back to the mother's encounter.

                                      Refer to the Notes section in the Patient resource for further details.

                                      Control0..1
                                      TypeReference(Encounter)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))