CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
1.0.0 - Release 1

CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG - Downloaded Version 1.0.0 See the Directory of published versions

## Resource Profile: ACH Monthly Event Encounter

Official URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/ach-monthly-encounter | Version: 1.0.0
Standards status: Trial-use | Maturity Level: 1 | Computable Name: AcuteCareHospitalMonthlyReportingEncounter

This profile contains Required and Must Support data elements for reporting encounter information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® US Core Encounter Profile v3.1.1.

Usages:

- Examples for this Profile: Encounter/encounter-example-ach-monthly-pass1, Encounter/encounter-example-ach-monthly-pass2-emergency, Encounter/encounter-example-ach-monthly-pass2-inpatient, Encounter/encounter-example-ach-monthly-pass3-acute and Encounter/encounter-example-ach-monthly-pass3-short-stay

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter | C | 0..* | USCoreEncounterProfile | An interaction during which services are provided to the patient Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
id | Σ | 1..1 | id | Logical id of this artifact
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..* | Identifier | Identifier(s) by which this encounter is known
use | ?!S Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
period | S Σ | 0..1 | Period | Time period when id is/was valid for use
status | ?!S Σ | 1..1 | code | triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
class | S Σ | 1..1 | Coding | Classification of patient encounter Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
classHistory | S | 0..* | BackboneElement | List of past encounter classes
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
class |  | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified class
type | S Σ | 1..* | CodeableConcept | Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | The patient or group present at the encounter
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
participant | S Σ | 0..* | BackboneElement | List of participants involved in the encounter
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period | S | 0..1 | Period | Period of time during the encounter that the participant participated
individual | S Σ | 0..1 | Reference(US Core Practitioner Profile) | Persons involved in the encounter other than the patient
period | S | 1..1 | Period | The start and end time of the encounter
reasonCode | S Σ | 0..* | CodeableConcept | Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
diagnosis | S Σ | 0..* | BackboneElement | The list of diagnosis relevant to this encounter
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
condition | Σ | 1..1 | Reference(Condition | Procedure) | The diagnosis or procedure relevant to the encounter
use | S | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank | S | 0..1 | positiveInt | Ranking of the diagnosis (for each role type)
hospitalization | S | 0..1 | BackboneElement | Details about the admission to a healthcare service
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
origin | S | 0..1 | Reference(Location | Organization) | The location/organization from which the patient came before admission
admitSource | S | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission | S | 0..1 | CodeableConcept | The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (preferred)
dietPreference | S | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: Diet (preferred)
dischargeDisposition | S | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: DischargeDisposition (preferred)
location | S | 1..* | BackboneElement | List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
location | S | 1..1 | Reference(Location) | Location the encounter takes place
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
status | S | 0..1 | code | planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType | S | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
period |  | 1..1 | Period | Time period during which the patient was present at the location
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Encounter.identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Encounter.identifier.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
Encounter.status | required | AcuteCareHospitalMonthlyEncounterStatus `http://www.cdc.gov/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-status` From this IG
Encounter.class | extensible | ActEncounterCode `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0`
Encounter.classHistory.class | extensible | ActEncounterCode `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0`
Encounter.type | extensible | USCoreEncounterType `http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type`
Encounter.participant.type | extensible | ParticipantType `http://hl7.org/fhir/ValueSet/encounter-participant-type` From the FHIR Standard
Encounter.reasonCode | preferred | EncounterReasonCodes `http://hl7.org/fhir/ValueSet/encounter-reason` From the FHIR Standard
Encounter.diagnosis.use | preferred | DiagnosisRole `http://hl7.org/fhir/ValueSet/diagnosis-role` From the FHIR Standard
Encounter.hospitalization.admitSource | preferred | AdmitSource `http://hl7.org/fhir/ValueSet/encounter-admit-source` From the FHIR Standard
Encounter.hospitalization.reAdmission | preferred | Hl7VSReAdmissionIndicator `http://terminology.hl7.org/ValueSet/v2-0092`
Encounter.hospitalization.dietPreference | preferred | Diet `http://hl7.org/fhir/ValueSet/encounter-diet` From the FHIR Standard
Encounter.hospitalization.dischargeDisposition | preferred | DischargeDisposition `http://hl7.org/fhir/ValueSet/encounter-discharge-disposition` From the FHIR Standard
Encounter.location.status | required | EncounterLocationStatus `http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1` From the FHIR Standard
Encounter.location.physicalType | extensible | LocationType `http://hl7.org/fhir/ValueSet/location-physical-type` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Encounter | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Encounter | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
encounter-ach-monthly-initial-population | error | Encounter | Encounter: (class must be from ACH Monthly encounter class) or (type from 'Encounter Inpatient', 'Emergency Department Visit', or 'Observation Services') or (Encounter location type from 'Inpatient, Emergency, and Observation Locations') : class.memberOf('http://www.cdc.gov/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-class') or class.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.274') or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143')).exists() or location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() |
encounter-location-type-initial-population | warning | Encounter | Encounter: references at least one Location where type is from 'Inpatient, Emergency, and Observation Locations' : location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() or location.where(location.resolve().partOf.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from USCoreEncounterProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter | C | 0..* | USCoreEncounterProfile | An interaction during which services are provided to the patient Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
id |  | 1..1 | id | Logical id of this artifact
meta |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:link-received-date-extension |  | 0..1 | dateTime | Received Date URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
identifier |  | 1..* | Identifier | Identifier(s) by which this encounter is known
use | S | 0..1 | code | usual | official | temp | secondary | old (If known)
type | S | 0..1 | CodeableConcept | Description of identifier
period | S | 0..1 | Period | Time period when id is/was valid for use
status |  | 1..1 | code | triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
classHistory | S | 0..* | BackboneElement | List of past encounter classes
subject |  |  |  |
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
period |  | 1..1 | Period | The start and end time of the encounter
diagnosis | S | 0..* | BackboneElement | The list of diagnosis relevant to this encounter
use | S | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
rank | S | 0..1 | positiveInt | Ranking of the diagnosis (for each role type)
hospitalization |  |  |  |
origin | S | 0..1 | Reference(Location | Organization) | The location/organization from which the patient came before admission
admitSource | S | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer)
reAdmission | S | 0..1 | CodeableConcept | The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (preferred)
dietPreference | S | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: Diet (preferred)
dischargeDisposition |  | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: DischargeDisposition (preferred)
location |  | 1..* | BackboneElement | List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
location |  |  |  |
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
status | S | 0..1 | code | planned | active | reserved | completed
physicalType | S | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
period |  | 1..1 | Period | Time period during which the patient was present at the location
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Encounter.status | required | AcuteCareHospitalMonthlyEncounterStatus `http://www.cdc.gov/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-status` From this IG
Encounter.hospitalization.reAdmission | preferred | Hl7VSReAdmissionIndicator `http://terminology.hl7.org/ValueSet/v2-0092`
Encounter.hospitalization.dietPreference | preferred | Diet `http://hl7.org/fhir/ValueSet/encounter-diet` From the FHIR Standard
Encounter.hospitalization.dischargeDisposition | preferred | DischargeDisposition `http://hl7.org/fhir/ValueSet/encounter-discharge-disposition` From the FHIR Standard
Encounter.location.physicalType | extensible | LocationType `http://hl7.org/fhir/ValueSet/location-physical-type` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
encounter-ach-monthly-initial-population | error | Encounter | Encounter: (class must be from ACH Monthly encounter class) or (type from 'Encounter Inpatient', 'Emergency Department Visit', or 'Observation Services') or (Encounter location type from 'Inpatient, Emergency, and Observation Locations') : class.memberOf('http://www.cdc.gov/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-class') or class.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.274') or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143')).exists() or location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() |
encounter-location-type-initial-population | warning | Encounter | Encounter: references at least one Location where type is from 'Inpatient, Emergency, and Observation Locations' : location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() or location.where(location.resolve().partOf.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() |

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter | C | 0..* | USCoreEncounterProfile | An interaction during which services are provided to the patient Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
id | Σ | 1..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:link-received-date-extension |  | 0..1 | dateTime | Received Date URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..* | Identifier | Identifier(s) by which this encounter is known
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!S Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
period | S Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!S Σ | 1..1 | code | triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
statusHistory |  | 0..* | BackboneElement | List of past encounter statuses
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
status |  | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified status
class | S Σ | 1..1 | Coding | Classification of patient encounter Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
classHistory | S | 0..* | BackboneElement | List of past encounter classes
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
class |  | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified class
type | S Σ | 1..* | CodeableConcept | Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
serviceType | Σ | 0..1 | CodeableConcept | Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority |  | 0..1 | CodeableConcept | Indicates the urgency of the encounter Binding: ActPriority (3.0.0) (example): Indicates the urgency of the encounter.
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | The patient or group present at the encounter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
episodeOfCare | Σ | 0..* | Reference(EpisodeOfCare) | Episode(s) of care that this encounter should be recorded against
basedOn |  | 0..* | Reference(ServiceRequest) | The ServiceRequest that initiated this encounter
participant | S Σ | 0..* | BackboneElement | List of participants involved in the encounter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period | S | 0..1 | Period | Period of time during the encounter that the participant participated
individual | S Σ | 0..1 | Reference(US Core Practitioner Profile) | Persons involved in the encounter other than the patient
appointment | Σ | 0..* | Reference(Appointment) | The appointment that scheduled this encounter
period | S | 1..1 | Period | The start and end time of the encounter
length |  | 0..1 | Duration | Quantity of time the encounter lasted (less time absent)
reasonCode | S Σ | 0..* | CodeableConcept | Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference | Σ | 0..* | Reference(Condition | Procedure | Observation | ImmunizationRecommendation) | Reason the encounter takes place (reference)
diagnosis | S Σ | 0..* | BackboneElement | The list of diagnosis relevant to this encounter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
condition | Σ | 1..1 | Reference(Condition | Procedure) | The diagnosis or procedure relevant to the encounter
use | S | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank | S | 0..1 | positiveInt | Ranking of the diagnosis (for each role type)
account |  | 0..* | Reference(Account) | The set of accounts that may be used for billing for this Encounter
hospitalization | S | 0..1 | BackboneElement | Details about the admission to a healthcare service
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier |  | 0..1 | Identifier | Pre-admission identifier
origin | S | 0..1 | Reference(Location | Organization) | The location/organization from which the patient came before admission
admitSource | S | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission | S | 0..1 | CodeableConcept | The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (preferred)
dietPreference | S | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: Diet (preferred)
specialCourtesy |  | 0..* | CodeableConcept | Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement |  | 0..* | CodeableConcept | Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination |  | 0..1 | Reference(Location | Organization) | Location/organization to which the patient is discharged
dischargeDisposition | S | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: DischargeDisposition (preferred)
location | S | 1..* | BackboneElement | List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
location | S | 1..1 | Reference(Location) | Location the encounter takes place
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
status | S | 0..1 | code | planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType | S | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
period |  | 1..1 | Period | Time period during which the patient was present at the location
serviceProvider |  | 0..1 | Reference(Organization) | The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(Encounter) | Another Encounter this encounter is part of
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Encounter.meta.security | extensible | All Security Labels `http://hl7.org/fhir/ValueSet/security-labels|4.0.1` From the FHIR Standard
Encounter.meta.tag | example | CommonTags `http://hl7.org/fhir/ValueSet/common-tags|4.0.1` From the FHIR Standard
Encounter.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Encounter.identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Encounter.identifier.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
Encounter.status | required | AcuteCareHospitalMonthlyEncounterStatus `http://www.cdc.gov/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-status` From this IG
Encounter.statusHistory.status | required | EncounterStatus `http://hl7.org/fhir/ValueSet/encounter-status|4.0.1` From the FHIR Standard
Encounter.class | extensible | ActEncounterCode `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0`
Encounter.classHistory.class | extensible | ActEncounterCode `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0`
Encounter.type | extensible | USCoreEncounterType `http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type`
Encounter.serviceType | example | ServiceType `http://hl7.org/fhir/ValueSet/service-type` From the FHIR Standard
Encounter.priority | example | ActPriority `http://terminology.hl7.org/ValueSet/v3-ActPriority|3.0.0`
Encounter.subject.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` From the FHIR Standard
Encounter.participant.type | extensible | ParticipantType `http://hl7.org/fhir/ValueSet/encounter-participant-type` From the FHIR Standard
Encounter.reasonCode | preferred | EncounterReasonCodes `http://hl7.org/fhir/ValueSet/encounter-reason` From the FHIR Standard
Encounter.diagnosis.use | preferred | DiagnosisRole `http://hl7.org/fhir/ValueSet/diagnosis-role` From the FHIR Standard
Encounter.hospitalization.admitSource | preferred | AdmitSource `http://hl7.org/fhir/ValueSet/encounter-admit-source` From the FHIR Standard
Encounter.hospitalization.reAdmission | preferred | Hl7VSReAdmissionIndicator `http://terminology.hl7.org/ValueSet/v2-0092`
Encounter.hospitalization.dietPreference | preferred | Diet `http://hl7.org/fhir/ValueSet/encounter-diet` From the FHIR Standard
Encounter.hospitalization.specialCourtesy | preferred | SpecialCourtesy `http://hl7.org/fhir/ValueSet/encounter-special-courtesy` From the FHIR Standard
Encounter.hospitalization.specialArrangement | preferred | SpecialArrangements `http://hl7.org/fhir/ValueSet/encounter-special-arrangements` From the FHIR Standard
Encounter.hospitalization.dischargeDisposition | preferred | DischargeDisposition `http://hl7.org/fhir/ValueSet/encounter-discharge-disposition` From the FHIR Standard
Encounter.location.location.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` From the FHIR Standard
Encounter.location.status | required | EncounterLocationStatus `http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1` From the FHIR Standard
Encounter.location.physicalType | extensible | LocationType `http://hl7.org/fhir/ValueSet/location-physical-type` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Encounter | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Encounter | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
encounter-ach-monthly-initial-population | error | Encounter | Encounter: (class must be from ACH Monthly encounter class) or (type from 'Encounter Inpatient', 'Emergency Department Visit', or 'Observation Services') or (Encounter location type from 'Inpatient, Emergency, and Observation Locations') : class.memberOf('http://www.cdc.gov/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-class') or class.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.274') or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143')).exists() or location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() |
encounter-location-type-initial-population | warning | Encounter | Encounter: references at least one Location where type is from 'Inpatient, Emergency, and Observation Locations' : location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() or location.where(location.resolve().partOf.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from USCoreEncounterProfile

Summary

Mandatory: 7 elements
Must-Support: 15 elements

Extensions

This structure refers to these extensions:

- http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter | C | 0..* | USCoreEncounterProfile | An interaction during which services are provided to the patient Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
id | Σ | 1..1 | id | Logical id of this artifact
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..* | Identifier | Identifier(s) by which this encounter is known
use | ?!S Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
period | S Σ | 0..1 | Period | Time period when id is/was valid for use
status | ?!S Σ | 1..1 | code | triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
class | S Σ | 1..1 | Coding | Classification of patient encounter Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
classHistory | S | 0..* | BackboneElement | List of past encounter classes
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
class |  | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified class
type | S Σ | 1..* | CodeableConcept | Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | The patient or group present at the encounter
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
participant | S Σ | 0..* | BackboneElement | List of participants involved in the encounter
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period | S | 0..1 | Period | Period of time during the encounter that the participant participated
individual | S Σ | 0..1 | Reference(US Core Practitioner Profile) | Persons involved in the encounter other than the patient
period | S | 1..1 | Period | The start and end time of the encounter
reasonCode | S Σ | 0..* | CodeableConcept | Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
diagnosis | S Σ | 0..* | BackboneElement | The list of diagnosis relevant to this encounter
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
condition | Σ | 1..1 | Reference(Condition | Procedure) | The diagnosis or procedure relevant to the encounter
use | S | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank | S | 0..1 | positiveInt | Ranking of the diagnosis (for each role type)
hospitalization | S | 0..1 | BackboneElement | Details about the admission to a healthcare service
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
origin | S | 0..1 | Reference(Location | Organization) | The location/organization from which the patient came before admission
admitSource | S | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission | S | 0..1 | CodeableConcept | The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (preferred)
dietPreference | S | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: Diet (preferred)
dischargeDisposition | S | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: DischargeDisposition (preferred)
location | S | 1..* | BackboneElement | List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
location | S | 1..1 | Reference(Location) | Location the encounter takes place
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
status | S | 0..1 | code | planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType | S | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
period |  | 1..1 | Period | Time period during which the patient was present at the location
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Encounter.identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Encounter.identifier.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
Encounter.status | required | AcuteCareHospitalMonthlyEncounterStatus `http://www.cdc.gov/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-status` From this IG
Encounter.class | extensible | ActEncounterCode `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0`
Encounter.classHistory.class | extensible | ActEncounterCode `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0`
Encounter.type | extensible | USCoreEncounterType `http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type`
Encounter.participant.type | extensible | ParticipantType `http://hl7.org/fhir/ValueSet/encounter-participant-type` From the FHIR Standard
Encounter.reasonCode | preferred | EncounterReasonCodes `http://hl7.org/fhir/ValueSet/encounter-reason` From the FHIR Standard
Encounter.diagnosis.use | preferred | DiagnosisRole `http://hl7.org/fhir/ValueSet/diagnosis-role` From the FHIR Standard
Encounter.hospitalization.admitSource | preferred | AdmitSource `http://hl7.org/fhir/ValueSet/encounter-admit-source` From the FHIR Standard
Encounter.hospitalization.reAdmission | preferred | Hl7VSReAdmissionIndicator `http://terminology.hl7.org/ValueSet/v2-0092`
Encounter.hospitalization.dietPreference | preferred | Diet `http://hl7.org/fhir/ValueSet/encounter-diet` From the FHIR Standard
Encounter.hospitalization.dischargeDisposition | preferred | DischargeDisposition `http://hl7.org/fhir/ValueSet/encounter-discharge-disposition` From the FHIR Standard
Encounter.location.status | required | EncounterLocationStatus `http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1` From the FHIR Standard
Encounter.location.physicalType | extensible | LocationType `http://hl7.org/fhir/ValueSet/location-physical-type` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Encounter | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Encounter | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
encounter-ach-monthly-initial-population | error | Encounter | Encounter: (class must be from ACH Monthly encounter class) or (type from 'Encounter Inpatient', 'Emergency Department Visit', or 'Observation Services') or (Encounter location type from 'Inpatient, Emergency, and Observation Locations') : class.memberOf('http://www.cdc.gov/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-class') or class.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.274') or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143')).exists() or location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() |
encounter-location-type-initial-population | warning | Encounter | Encounter: references at least one Location where type is from 'Inpatient, Emergency, and Observation Locations' : location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() or location.where(location.resolve().partOf.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

Differential View

This structure is derived from USCoreEncounterProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter | C | 0..* | USCoreEncounterProfile | An interaction during which services are provided to the patient Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
id |  | 1..1 | id | Logical id of this artifact
meta |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:link-received-date-extension |  | 0..1 | dateTime | Received Date URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
identifier |  | 1..* | Identifier | Identifier(s) by which this encounter is known
use | S | 0..1 | code | usual | official | temp | secondary | old (If known)
type | S | 0..1 | CodeableConcept | Description of identifier
period | S | 0..1 | Period | Time period when id is/was valid for use
status |  | 1..1 | code | triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
classHistory | S | 0..* | BackboneElement | List of past encounter classes
subject |  |  |  |
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
period |  | 1..1 | Period | The start and end time of the encounter
diagnosis | S | 0..* | BackboneElement | The list of diagnosis relevant to this encounter
use | S | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
rank | S | 0..1 | positiveInt | Ranking of the diagnosis (for each role type)
hospitalization |  |  |  |
origin | S | 0..1 | Reference(Location | Organization) | The location/organization from which the patient came before admission
admitSource | S | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer)
reAdmission | S | 0..1 | CodeableConcept | The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (preferred)
dietPreference | S | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: Diet (preferred)
dischargeDisposition |  | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: DischargeDisposition (preferred)
location |  | 1..* | BackboneElement | List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
location |  |  |  |
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
status | S | 0..1 | code | planned | active | reserved | completed
physicalType | S | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
period |  | 1..1 | Period | Time period during which the patient was present at the location
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Encounter.status | required | AcuteCareHospitalMonthlyEncounterStatus `http://www.cdc.gov/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-status` From this IG
Encounter.hospitalization.reAdmission | preferred | Hl7VSReAdmissionIndicator `http://terminology.hl7.org/ValueSet/v2-0092`
Encounter.hospitalization.dietPreference | preferred | Diet `http://hl7.org/fhir/ValueSet/encounter-diet` From the FHIR Standard
Encounter.hospitalization.dischargeDisposition | preferred | DischargeDisposition `http://hl7.org/fhir/ValueSet/encounter-discharge-disposition` From the FHIR Standard
Encounter.location.physicalType | extensible | LocationType `http://hl7.org/fhir/ValueSet/location-physical-type` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
encounter-ach-monthly-initial-population | error | Encounter | Encounter: (class must be from ACH Monthly encounter class) or (type from 'Encounter Inpatient', 'Emergency Department Visit', or 'Observation Services') or (Encounter location type from 'Inpatient, Emergency, and Observation Locations') : class.memberOf('http://www.cdc.gov/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-class') or class.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.274') or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143')).exists() or location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() |
encounter-location-type-initial-population | warning | Encounter | Encounter: references at least one Location where type is from 'Inpatient, Emergency, and Observation Locations' : location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() or location.where(location.resolve().partOf.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter | C | 0..* | USCoreEncounterProfile | An interaction during which services are provided to the patient Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
id | Σ | 1..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:link-received-date-extension |  | 0..1 | dateTime | Received Date URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..* | Identifier | Identifier(s) by which this encounter is known
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!S Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
period | S Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!S Σ | 1..1 | code | triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
statusHistory |  | 0..* | BackboneElement | List of past encounter statuses
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
status |  | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified status
class | S Σ | 1..1 | Coding | Classification of patient encounter Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
classHistory | S | 0..* | BackboneElement | List of past encounter classes
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
class |  | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified class
type | S Σ | 1..* | CodeableConcept | Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
serviceType | Σ | 0..1 | CodeableConcept | Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority |  | 0..1 | CodeableConcept | Indicates the urgency of the encounter Binding: ActPriority (3.0.0) (example): Indicates the urgency of the encounter.
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | The patient or group present at the encounter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
episodeOfCare | Σ | 0..* | Reference(EpisodeOfCare) | Episode(s) of care that this encounter should be recorded against
basedOn |  | 0..* | Reference(ServiceRequest) | The ServiceRequest that initiated this encounter
participant | S Σ | 0..* | BackboneElement | List of participants involved in the encounter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period | S | 0..1 | Period | Period of time during the encounter that the participant participated
individual | S Σ | 0..1 | Reference(US Core Practitioner Profile) | Persons involved in the encounter other than the patient
appointment | Σ | 0..* | Reference(Appointment) | The appointment that scheduled this encounter
period | S | 1..1 | Period | The start and end time of the encounter
length |  | 0..1 | Duration | Quantity of time the encounter lasted (less time absent)
reasonCode | S Σ | 0..* | CodeableConcept | Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference | Σ | 0..* | Reference(Condition | Procedure | Observation | ImmunizationRecommendation) | Reason the encounter takes place (reference)
diagnosis | S Σ | 0..* | BackboneElement | The list of diagnosis relevant to this encounter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
condition | Σ | 1..1 | Reference(Condition | Procedure) | The diagnosis or procedure relevant to the encounter
use | S | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank | S | 0..1 | positiveInt | Ranking of the diagnosis (for each role type)
account |  | 0..* | Reference(Account) | The set of accounts that may be used for billing for this Encounter
hospitalization | S | 0..1 | BackboneElement | Details about the admission to a healthcare service
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier |  | 0..1 | Identifier | Pre-admission identifier
origin | S | 0..1 | Reference(Location | Organization) | The location/organization from which the patient came before admission
admitSource | S | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission | S | 0..1 | CodeableConcept | The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (preferred)
dietPreference | S | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: Diet (preferred)
specialCourtesy |  | 0..* | CodeableConcept | Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement |  | 0..* | CodeableConcept | Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination |  | 0..1 | Reference(Location | Organization) | Location/organization to which the patient is discharged
dischargeDisposition | S | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: DischargeDisposition (preferred)
location | S | 1..* | BackboneElement | List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
location | S | 1..1 | Reference(Location) | Location the encounter takes place
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
status | S | 0..1 | code | planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType | S | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
period |  | 1..1 | Period | Time period during which the patient was present at the location
serviceProvider |  | 0..1 | Reference(Organization) | The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(Encounter) | Another Encounter this encounter is part of
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Encounter.meta.security | extensible | All Security Labels `http://hl7.org/fhir/ValueSet/security-labels|4.0.1` From the FHIR Standard
Encounter.meta.tag | example | CommonTags `http://hl7.org/fhir/ValueSet/common-tags|4.0.1` From the FHIR Standard
Encounter.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Encounter.identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Encounter.identifier.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
Encounter.status | required | AcuteCareHospitalMonthlyEncounterStatus `http://www.cdc.gov/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-status` From this IG
Encounter.statusHistory.status | required | EncounterStatus `http://hl7.org/fhir/ValueSet/encounter-status|4.0.1` From the FHIR Standard
Encounter.class | extensible | ActEncounterCode `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0`
Encounter.classHistory.class | extensible | ActEncounterCode `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0`
Encounter.type | extensible | USCoreEncounterType `http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type`
Encounter.serviceType | example | ServiceType `http://hl7.org/fhir/ValueSet/service-type` From the FHIR Standard
Encounter.priority | example | ActPriority `http://terminology.hl7.org/ValueSet/v3-ActPriority|3.0.0`
Encounter.subject.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` From the FHIR Standard
Encounter.participant.type | extensible | ParticipantType `http://hl7.org/fhir/ValueSet/encounter-participant-type` From the FHIR Standard
Encounter.reasonCode | preferred | EncounterReasonCodes `http://hl7.org/fhir/ValueSet/encounter-reason` From the FHIR Standard
Encounter.diagnosis.use | preferred | DiagnosisRole `http://hl7.org/fhir/ValueSet/diagnosis-role` From the FHIR Standard
Encounter.hospitalization.admitSource | preferred | AdmitSource `http://hl7.org/fhir/ValueSet/encounter-admit-source` From the FHIR Standard
Encounter.hospitalization.reAdmission | preferred | Hl7VSReAdmissionIndicator `http://terminology.hl7.org/ValueSet/v2-0092`
Encounter.hospitalization.dietPreference | preferred | Diet `http://hl7.org/fhir/ValueSet/encounter-diet` From the FHIR Standard
Encounter.hospitalization.specialCourtesy | preferred | SpecialCourtesy `http://hl7.org/fhir/ValueSet/encounter-special-courtesy` From the FHIR Standard
Encounter.hospitalization.specialArrangement | preferred | SpecialArrangements `http://hl7.org/fhir/ValueSet/encounter-special-arrangements` From the FHIR Standard
Encounter.hospitalization.dischargeDisposition | preferred | DischargeDisposition `http://hl7.org/fhir/ValueSet/encounter-discharge-disposition` From the FHIR Standard
Encounter.location.location.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` From the FHIR Standard
Encounter.location.status | required | EncounterLocationStatus `http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1` From the FHIR Standard
Encounter.location.physicalType | extensible | LocationType `http://hl7.org/fhir/ValueSet/location-physical-type` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Encounter | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Encounter | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
encounter-ach-monthly-initial-population | error | Encounter | Encounter: (class must be from ACH Monthly encounter class) or (type from 'Encounter Inpatient', 'Emergency Department Visit', or 'Observation Services') or (Encounter location type from 'Inpatient, Emergency, and Observation Locations') : class.memberOf('http://www.cdc.gov/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-class') or class.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.274') or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143')).exists() or location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() |
encounter-location-type-initial-population | warning | Encounter | Encounter: references at least one Location where type is from 'Inpatient, Emergency, and Observation Locations' : location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() or location.where(location.resolve().partOf.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from USCoreEncounterProfile

Summary

Mandatory: 7 elements
Must-Support: 15 elements

Extensions

This structure refers to these extensions:

- http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension

Maturity: 1

Other representations of profile: CSV, Excel, Schematron