# Hospitalisierung (Hospitalization)

https://demis.rki.de/fhir/StructureDefinition/Hospitalization

Insbesondere vor dem Hintergrund der Ermittlung der Hospitalisierungsinzidenz ist das im Folgenden diskutierte Profil von besonderer Bedeutung. Mit seiner Hilfe können detaillierte Angaben zum Hospitalisierungsstatus einer betroffen Person gemacht werden. Das Hospitalization-Profil definiert seine Einschränkungen und Erweiterungen direkt auf der HL7 Encounter-Definition.

Ressourcen, die dieses Profil umsetzen, können die folgenden logischen Informationen als Bestandteil der Meldung transportieren:

Die Profilierung nimmt eine Reihe von Einschränkungen und Festlegungen vor, die primär die Verwendung bestimmter Elemente (z.B. type) unterbindet bzw. anderer Elemente (z.B. serviceType, period) fordert. Neben diesen Einschränkungen werden zusätzlich zwei Erweiterungen vorgenommen:

- Region der Hospitalisierung - zu nutzen, sofern kein konkretes Krankenhaus über serviceProvider referenziert werden kann
- Hinweise/Notizen zur Hospitalisierung - zu nutzen, sofern die meldepflichtige Person dem Gesundheitsamt gegenüber wichtige Hinweise zur Hospitalisierung übermitteln möchte.

Mit Blick auf das oben abgebildete logische Informationsmodell ergibt sich eine weitere Besonderheit: Ein Aufenthalt auf einer Intensivstation wird nicht anders dargestellt als der Aufenthalt auf einer "normalen" Station. Eine Unterscheidung findet ausschließlich über den angegebenen serviceType statt.

Profilansicht

Hospitalization (Encounter) | C |  | Encounter | There are no (further) constraints on this element Element id
    Encounter
Short description An interaction during which services are provided to the patient Alternate names Visit 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. Data type Encounter Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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-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-6: A resource should have narrative for robust management `text.`div`.exists()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` Mappings rim: Entity. Role, or Act workflow: Event rim: Encounter[@moodCode='EVN']
id | Σ | 0..1 | string | There are no (further) constraints on this element Element id
    Encounter.id
Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. 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. Data type string
meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element id
    Encounter.meta
Short description Metadata about the resource 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. Data type Meta Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element id
    Encounter.implicitRules
Short description A set of rules under which this content was created 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. 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. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
language |  | 0..1 | code Binding | There are no (further) constraints on this element Element id
    Encounter.language
Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Binding extensions
maxValueSet | AllLanguages
Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
text |  | 0..1 | Narrative | There are no (further) constraints on this element Element id
    Encounter.text
Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display 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. 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. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained |  | 0..* | Resource | There are no (further) constraints on this element Element id
    Encounter.contained
Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources 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. 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. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension | C | 0..* | Extension | Element id
    Encounter.extension
Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-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()` Mappings rim: n/a rim: N/A
hospitalizationNote | S C | 0..1 | Extension(string) | Element id
    Encounter.extension:hospitalizationNote
Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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. Data type Extension(string) Extension URL https://demis.rki.de/fhir/StructureDefinition/HospitalizationNote Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-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()` Mappings rim: n/a rim: N/A
hospitalizationRegion | S C | 0..1 | Extension(CodeableConcept) | Element id
    Encounter.extension:hospitalizationRegion
Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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. Data type Extension(CodeableConcept) Extension URL https://demis.rki.de/fhir/StructureDefinition/HospitalizationRegion Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-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()` Mappings rim: n/a rim: N/A
modifierExtension | ?! C | 0..* | Extension | There are no (further) constraints on this element Element id
    Encounter.modifierExtension
Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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. 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-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()` Mappings rim: n/a rim: N/A
identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element id
    Encounter.identifier
Short description Identifier(s) by which this encounter is known Definition Identifier(s) by which this encounter is known. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Event.identifier w5: FiveWs.identifier v2: PV1-19 rim: .id
status | S Σ ?! | 1..1 | code Binding | Element id
    Encounter.status
Short description Status der Hospitalisierung Definition Status der Hospitalisierung Comments Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes). Data type code Binding Current state of the encounter. EncounterStatus (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Event.status w5: FiveWs.status v2: No clear equivalent in HL7 v2; active/finished could be inferred from PV1-44, PV1-45, PV2-24; inactive could be inferred from PV2-16 rim: .statusCode
statusHistory |  | 0..0 | BackboneElement | There are no (further) constraints on this element Element id
    Encounter.statusHistory
Short description List of past encounter statuses 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. Comments The current status is always found in the current version of the resource, not the status history. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
class | Σ | 1..1 | Coding Binding | There are no (further) constraints on this element Element id
    Encounter.class
Short description Classification of patient encounter Definition Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations. 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. Data type Coding Binding Classification of the encounter. v3.ActEncounterCode (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding w5: FiveWs.class v2: PV1-2 rim: .inboundRelationship[typeCode=SUBJ].source[classCode=LIST].code
classHistory |  | 0..0 | BackboneElement | There are no (further) constraints on this element Element id
    Encounter.classHistory
Short description List of past encounter classes 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
type | Σ | 0..0 | CodeableConcept | There are no (further) constraints on this element Element id
    Encounter.type
Short description Specific type of encounter Definition Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation). Comments Since there are many ways to further classify encounters, this element is 0..*. Data type CodeableConcept Binding The type of encounter. EncounterType (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.code w5: FiveWs.class v2: PV1-4 / PV1-18 rim: .code
serviceType | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element id
    Encounter.serviceType
Short description Specific type of service Definition Broad categorization of the service that is to be provided (e.g. cardiology). Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding Broad categorization of the service that is to be provided. ServiceType (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.code v2: PV1-10
id |  | 0..1 | string | There are no (further) constraints on this element Element id
    Encounter.serviceType.id
Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension | C | 0..* | Extension | There are no (further) constraints on this element Element id
    Encounter.serviceType.extension
Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-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()` Mappings rim: n/a rim: N/A
coding | S Σ | 1..1 | Coding Binding | Element id
    Encounter.serviceType.coding
Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. 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. Data type Coding Binding Art der Hospitalisierung HospitalizationServiceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id |  | 0..1 | string | There are no (further) constraints on this element Element id
    Encounter.serviceType.coding.id
Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension | C | 0..* | Extension | There are no (further) constraints on this element Element id
    Encounter.serviceType.coding.extension
Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-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()` Mappings rim: n/a rim: N/A
system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element id
    Encounter.serviceType.coding.system
Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. 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. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version | Σ | 0..1 | string | There are no (further) constraints on this element Element id
    Encounter.serviceType.coding.version
Short description Version of the system - if relevant 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. 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element id
    Encounter.serviceType.coding.code
Short description Symbol in syntax defined by the system 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). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display | Σ | 0..1 | string | There are no (further) constraints on this element Element id
    Encounter.serviceType.coding.display
Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element id
    Encounter.serviceType.coding.userSelected
Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text | Σ | 0..1 | string | There are no (further) constraints on this element Element id
    Encounter.serviceType.text
Short description Plain text representation of the concept 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. 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
priority |  | 0..0 | CodeableConcept | There are no (further) constraints on this element Element id
    Encounter.priority
Short description Indicates the urgency of the encounter Definition Indicates the urgency of the encounter. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding Indicates the urgency of the encounter. v3.ActPriority (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.grade v2: PV2-25 rim: .priorityCode
subject | S Σ C | 1..1 | Reference(https://demis.rki.de/fhir/StructureDefinition/NotifiedPerson | https://demis.rki.de/fhir/StructureDefinition/NotifiedPersonAnonymous) | Element id
    Encounter.subject
Short description Verweis auf die in der Meldung benannte betroffene Person Alternate names patient Definition Verweis auf die in der Meldung benannte betroffene Person. Hierbei handelt es sich grundsätzlich um den Verweis auf die in der Erregernachweismeldung als „subject“ referenzierte Patient Ressource. Comments 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). Data type Reference(https://demis.rki.de/fhir/StructureDefinition/NotifiedPerson | https://demis.rki.de/fhir/StructureDefinition/NotifiedPersonAnonymous) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3 rim: .participation[typeCode=SBJ]/role[classCode=PAT] w5: FiveWs.subject
id |  | 0..1 | string | There are no (further) constraints on this element Element id
    Encounter.subject.id
Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension | C | 0..* | Extension | There are no (further) constraints on this element Element id
    Encounter.subject.extension
Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-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()` Mappings rim: n/a rim: N/A
reference | S Σ C | 1..1 | string | There are no (further) constraints on this element Element id
    Encounter.subject.reference
Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
type | Σ | 0..1 | uri Binding | There are no (further) constraints on this element Element id
    Encounter.subject.type
Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element id
    Encounter.subject.identifier
Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
display | Σ | 0..1 | string | There are no (further) constraints on this element Element id
    Encounter.subject.display
Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
episodeOfCare | Σ C | 0..0 | Reference(EpisodeOfCare) | There are no (further) constraints on this element Element id
    Encounter.episodeOfCare
Short description Episode(s) of care that this encounter should be recorded against 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). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(EpisodeOfCare) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.context w5: FiveWs.context v2: PV1-54, PV1-53
basedOn | C | 0..0 | Reference(ServiceRequest) | There are no (further) constraints on this element Element id
    Encounter.basedOn
Short description The ServiceRequest that initiated this encounter Alternate names incomingReferral Definition The request this encounter satisfies (e.g. incoming referral or procedure request). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(ServiceRequest) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.basedOn rim: .reason.ClinicalDocument
participant | Σ | 0..0 | BackboneElement | There are no (further) constraints on this element Element id
    Encounter.participant
Short description List of participants involved in the encounter Definition The list of people responsible for providing the service. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Event.performer v2: ROL rim: .participation[typeCode=PFM]
appointment | Σ C | 0..0 | Reference(Appointment) | There are no (further) constraints on this element Element id
    Encounter.appointment
Short description The appointment that scheduled this encounter Definition The appointment that scheduled this encounter. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Appointment) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.basedOn v2: SCH-1 / SCH-2 rim: .outboundRelationship[typeCode=FLFS].target[classCode=ENC, moodCode=APT]
period | S C | 1..1 | Period | Element id
    Encounter.period
Short description Dauer der Hospitalisierung Definition Dauer der Hospitalisierung Comments If not (yet) known, the end of the Period may be omitted. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] workflow: Event.occurrence[x] w5: FiveWs.done[x] v2: PV1-44, PV1-45 rim: .effectiveTime (low & high)
id |  | 0..1 | string | There are no (further) constraints on this element Element id
    Encounter.period.id
Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension | C | 0..* | Extension | There are no (further) constraints on this element Element id
    Encounter.period.extension
Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-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()` Mappings rim: n/a rim: N/A
start | S Σ C | 1..1 | dateTime | Element id
    Encounter.period.start
Short description Zeitpunkt des Beginns der Hospitalisierung Definition Zeitpunkt des Beginns der Hospitalisierung Comments If the low element is missing, the meaning is that the low boundary is not known. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1, per-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: DR.1 rim: ./low
end | Σ C | 0..1 | dateTime | Element id
    Encounter.period.end
Short description Zeitpunkt der Beendigung der Hospitalisierung Definition Zeitpunkt der Beendigung der Hospitalisierung Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1, per-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: DR.2 rim: ./high
length | C | 0..0 | Duration | There are no (further) constraints on this element Element id
    Encounter.length
Short description Quantity of time the encounter lasted (less time absent) Definition Quantity of time the encounter lasted. This excludes the time during leaves of absence. Comments May differ from the time the Encounter.period lasted because of leave of absence. Data type Duration Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. `code.exists() implies ((system = %ucum) and value.exists())` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values rim: PQ, IVL<PQ> depending on the values workflow: Event.occurrence[x] v2: (PV1-45 less PV1-44) iff ( (PV1-44 not empty) and (PV1-45 not empty) ); units in minutes rim: .lengthOfStayQuantity
reasonCode | S Σ | 0..1 | CodeableConcept Binding | Element id
    Encounter.reasonCode
Short description Hospitalisierungsgrund Alternate names Indication, Admission diagnosis Definition Hospitalisierungsgrund 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). Data type CodeableConcept Binding Reason why the encounter takes place. EncounterReasonCodes (preferred) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.reasonCode w5: FiveWs.why[x] v2: EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations ) rim: .reasonCode
id |  | 0..1 | string | There are no (further) constraints on this element Element id
    Encounter.reasonCode.id
Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension | C | 0..* | Extension | There are no (further) constraints on this element Element id
    Encounter.reasonCode.extension
Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-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()` Mappings rim: n/a rim: N/A
coding | S Σ | 1..1 | Coding Binding | Element id
    Encounter.reasonCode.coding
Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. 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. Data type Coding Binding Hospitalisierungsgrund AnswerSetHospitalizationReason (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id |  | 0..1 | string | There are no (further) constraints on this element Element id
    Encounter.reasonCode.coding.id
Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension | C | 0..* | Extension | There are no (further) constraints on this element Element id
    Encounter.reasonCode.coding.extension
Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-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()` Mappings rim: n/a rim: N/A
system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element id
    Encounter.reasonCode.coding.system
Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. 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. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version | Σ | 0..1 | string | There are no (further) constraints on this element Element id
    Encounter.reasonCode.coding.version
Short description Version of the system - if relevant 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. 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element id
    Encounter.reasonCode.coding.code
Short description Symbol in syntax defined by the system 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). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display | Σ | 0..1 | string | There are no (further) constraints on this element Element id
    Encounter.reasonCode.coding.display
Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element id
    Encounter.reasonCode.coding.userSelected
Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text | Σ | 0..0 | string | There are no (further) constraints on this element Element id
    Encounter.reasonCode.text
Short description Plain text representation of the concept 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. 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
reasonReference | Σ C | 0..0 | Reference(Condition | ImmunizationRecommendation | Observation | Procedure) | There are no (further) constraints on this element Element id
    Encounter.reasonReference
Short description Reason the encounter takes place (reference) Alternate names Indication, Admission diagnosis Definition Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis. 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). Data type Reference(Condition | ImmunizationRecommendation | Observation | Procedure) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.reasonCode w5: FiveWs.why[x] v2: EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations ) rim: .reasonCode
diagnosis | Σ | 0..0 | BackboneElement | There are no (further) constraints on this element Element id
    Encounter.diagnosis
Short description The list of diagnosis relevant to this encounter Definition The list of diagnosis relevant to this encounter. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .outboundRelationship[typeCode=RSON]
account | C | 0..0 | Reference(Account) | There are no (further) constraints on this element Element id
    Encounter.account
Short description The set of accounts that may be used for billing for this Encounter Definition The 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. Data type Reference(Account) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .pertains.A_Account
hospitalization |  | 0..0 | BackboneElement | There are no (further) constraints on this element Element id
    Encounter.hospitalization
Short description Details about the admission to a healthcare service Definition Details 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. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .outboundRelationship[typeCode=COMP].target[classCode=ENC, moodCode=EVN]
location |  | 0..0 | BackboneElement | There are no (further) constraints on this element Element id
    Encounter.location
Short description List of locations where the patient has been Definition List of locations where the patient has been during this encounter. 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". Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .participation[typeCode=LOC]
serviceProvider | S C | 0..1 | Reference(Organization) | Element id
    Encounter.serviceProvider
Short description Krankenhaus Definition Krankenhaus in dem die Hospitalisierung erfolgte Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer.actor v2: PL.6 & PL.1 rim: .particiaption[typeCode=PFM].role
id |  | 0..1 | string | There are no (further) constraints on this element Element id
    Encounter.serviceProvider.id
Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension | C | 0..* | Extension | There are no (further) constraints on this element Element id
    Encounter.serviceProvider.extension
Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-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()` Mappings rim: n/a rim: N/A
reference | S Σ C | 1..1 | string | There are no (further) constraints on this element Element id
    Encounter.serviceProvider.reference
Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
type | Σ | 0..1 | uri Binding | There are no (further) constraints on this element Element id
    Encounter.serviceProvider.type
Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element id
    Encounter.serviceProvider.identifier
Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
display | Σ | 0..1 | string | There are no (further) constraints on this element Element id
    Encounter.serviceProvider.display
Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
partOf | C | 0..0 | Reference(Encounter) | There are no (further) constraints on this element Element id
    Encounter.partOf
Short description Another Encounter this encounter is part of Definition Another Encounter of which this encounter is a part of (administratively or in time). 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. Data type Reference(Encounter) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.partOf rim: .inboundRelationship[typeCode=COMP].source[classCode=COMP, moodCode=EVN]

Beispiel

<Encounter xmlns="http://hl7.org/fhir">
<id value="1a0e5fe7-dfca-3322-a2d0-57e801eb694d" />
<meta>
<profile value="https://demis.rki.de/fhir/StructureDefinition/Hospitalization" />
</meta>
<status value="in-progress" />
<class>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode" />
<code value="IMP" />
<display value="inpatient encounter" />
</class>
<serviceType>
<coding>
<system value="https://demis.rki.de/fhir/CodeSystem/hospitalizationServiceType" />
<code value="3600" />
<display value="Intensivmedizin" />
</coding>
</serviceType>
<subject>
<reference value="Patient/314b3907-1ee6-3f5f-8319-fce7d5aa2050" />
</subject>
<period>
<start value="2022-02-07" />
</period>
<reasonCode>
<coding>
<system value="https://demis.rki.de/fhir/CodeSystem/hospitalizationReason" />
<code value="becauseOfDisease" />
<display value="Hospitalisiert aufgrund der gemeldeten Krankheit" />
</coding>
</reasonCode>
<serviceProvider>
<reference value="Organization/54da7381-727b-3e1a-bbe5-ff37b64d7152" />
</serviceProvider>
</Encounter>

<Encounter xmlns="http://hl7.org/fhir">
<id value="b7ef195b-b7d8-3098-a6be-382c5207504c" />
<meta>
<profile value="https://demis.rki.de/fhir/StructureDefinition/Hospitalization" />
</meta>
<extension url="https://demis.rki.de/fhir/StructureDefinition/HospitalizationRegion">
<valueCodeableConcept>
<coding>
<system value="https://demis.rki.de/fhir/CodeSystem/geographicRegion" />
<code value="13000011" />
</coding>
</valueCodeableConcept>
</extension>
<status value="in-progress" />
<class>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode" />
<code value="IMP" />
<display value="inpatient encounter" />
</class>
<serviceType>
<coding>
<system value="https://demis.rki.de/fhir/CodeSystem/hospitalizationServiceType" />
<code value="0800" />
<display value="Pneumologie" />
</coding>
</serviceType>
<subject>
<reference value="Patient/51eddc9b-0ac4-360c-b89d-5478b696f6dc" />
</subject>
<period>
<start value="2021-03-04" />
<end value="2021-03-04" />
</period>
<reasonCode>
<coding>
<system value="https://demis.rki.de/fhir/CodeSystem/hospitalizationReason" />
<code value="becauseOfDisease" />
<display value="Hospitalisiert aufgrund der gemeldeten Krankheit" />
</coding>
</reasonCode>
<serviceProvider>
<reference value="Organization/e51f32e5-767f-32a1-99fd-1d2de606b5bc" />
</serviceProvider>
</Encounter>

<Encounter xmlns="http://hl7.org/fhir">
<id value="cf424cfb-8809-3b51-8ab2-d8bf979cbe8d" />
<meta>
<profile value="https://demis.rki.de/fhir/StructureDefinition/Hospitalization" />
</meta>
<status value="in-progress" />
<class>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode" />
<code value="IMP" />
<display value="inpatient encounter" />
</class>
<serviceType>
<coding>
<system value="https://demis.rki.de/fhir/CodeSystem/hospitalizationServiceType" />
<code value="0800" />
<display value="Pneumologie" />
</coding>
</serviceType>
<subject>
<reference value="Patient/ac163863-fefa-3ce2-8511-7a4150d6ad43" />
</subject>
<period>
<start value="2021-03-04" />
</period>
<reasonCode>
<coding>
<system value="https://demis.rki.de/fhir/CodeSystem/hospitalizationReason" />
<code value="becauseOfDisease" />
<display value="Hospitalisiert aufgrund der gemeldeten Krankheit" />
</coding>
</reasonCode>
<serviceProvider>
<reference value="Organization/7b1cb8d3-f4bb-3cf6-8c0e-01e6657a13ea" />
</serviceProvider>
</Encounter>