HRSA 2024 Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+) FHIR IG
2.0.0 - STU2 Release 1 - Standard for Trial-Use

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## Resource Profile: De-Identified UDS Plus Encounter

Official URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-encounter | Version: 2.0.0
Standards status: Trial-use | Maturity Level: 2 | Computable Name: UDSPlusEncounter

The UDS+ profile is based on the Encounter resource and establishes the core elements, extensions, vocabularies and value sets for representing encounters,visit information for UDS+ program.

### Introduction

This profile is used to represent de-identified Encounter information. The de-identification process has to remove all data elements not explicitly identified as "SUPPORTED" in the profile.

The HHS De-identification Guidance is to be followed to ensure appropriate level of de-identification is performed.

According to the HHS guidance, dates should not have a precision of more than the year. This means month and day cannot be included. This includes diagnosis dates, visit dates, onset dates etc.

In FHIR Resources, text elements and reference.display elements which provide human readable information to the providers may be generated using programs and tools from the data present within the resource. For e.g a Encounter resource text element may contain information such as the visit date. This type of information will enable identification of the individuals. In order to avoid inadvertent revealing of PII/PHI, text elements cannot be included in the De-identified FHIR resource and the submission will be rejected when text elements are present by the validation process.

Age Computation

The Data Submitter has to compute the age using the visit date of the encounter to be included in the UDS+ report.

Capturing Location Information

The Encounter.location.location points to a Location Resource. The Location.type element can be used to indicate the type of location where the service was provided. The existing Location.type value set can be used to indicate that the service was provided in a SCHOOL based setting. This will be used to compute Table 4, LINE 24 of the UDS Report. For Table 4, Line 26 use the public-housing code defined in UDS+ value set that is referenced in the UDS+ Location profile.

Ids and References

The original Encounter resource id should not be included in the De-identified Encounter instance. Instead a new id should be created and provided as part of the FHIR resource. This Data Submitter should be capable of using the generated id to relink the data to the original Encounter. All resource references to the Encounter submitted as part of the UDS+ report should refer to newly generated id.

Resource references cannot contain text element as it may contain PHI/PII. The text element for following references are not allowed

- subject
- reasonReference

Date Truncation

The Data Submitter has to truncate the following dates to only have a precision of year

- period and its sub elements.
- participant.period

Guidance on Encounter reason

The Encounter resource can represent a reason using either a code with Encounter.reasonCode, or a reference with Encounter.reasonReference to Condition or other resource.

- Although both are marked as Must Support, servers are not required to support both a code and a reference, but they SHALL support at least one of these elements.

Guidance on Encounter.serviceProvider

The Encounter.serviceProvider organization reference should point to the Organization resource that represents the FQHC which is responsible for rendering the services to the Patient.

Examples

Examples of identifiable data and its corresponding de-identifiable data is present in Reporting Guidance.

Usage:

- Refer to this Resource Profile: De-Identified UDS Plus Clinical Result Observation, De-Identified UDS Plus Diagnosis, De-Identified UDS Plus MedicationRequest, De-Identified UDS Plus Observation... Show 2 more, De-Identified UDS Plus Procedure and De-Identified UDS Plus ServiceRequest
- Examples for this Resource Profile: Encounter/de-identified-example

### 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
--- | --- | --- | --- | ---
Encounter |  | 0..* | Encounter | De-Identified UDS Plus Encounter dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
id | S Σ | 0..1 | id | The de-identified Encounter identifier created by the health center to send data to UDS+ Data Receiver
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:uds-plus-age-extension | S | 1..1 | Quantity | Age of the Patient computed using birthDate and the visit dates of the encounter URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status | ?!S Σ | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. ele-1: All FHIR elements must have a @value or children
class | S Σ | 1..1 | Coding | Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter. ele-1: All FHIR elements must have a @value or children
type | S Σ | 1..* | CodeableConcept | Specific type of encounter Binding: US Core Encounter Type (extensible): The set of codes indicating the type of encounter ele-1: All FHIR elements must have a @value or children
subject | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | The patient or group present at the encounter ele-1: All FHIR elements must have a @value or children
participant | S Σ | 0..* | BackboneElement | List of participants involved in the encounter ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type | S Σ | 0..* | CodeableConcept | Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter. ele-1: All FHIR elements must have a @value or children
period | S C | 0..1 | Period | Period of time during the encounter that the participant participated ele-1: All FHIR elements must have a @value or children uds-plus-enc-1: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-1a: All Period.start data elements should have valid year > 1900 uds-plus-enc-1b: All Period.start data elements should have valid year < 2030 uds-plus-enc-2: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-enc-2a: All Period.end data elements should have valid year > 1900 uds-plus-enc-2b: All Period.end data elements should have valid year < 2030
individual | S Σ | 0..1 | Reference(US Core Practitioner Profile) | Persons involved in the encounter other than the patient ele-1: All FHIR elements must have a @value or children
period | S C | 0..1 | Period | The start and end time of the encounter ele-1: All FHIR elements must have a @value or children uds-plus-enc-3: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-3a: All Period.start data elements should have valid year > 1900 uds-plus-enc-3b: All Period.start data elements should have valid year < 2030 uds-plus-enc-4: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-enc-4a: All Period.end data elements should have valid year > 1900 uds-plus-enc-4b: All Period.end data elements should have valid year < 2030
reasonCode | S Σ | 0..* | CodeableConcept | Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place. ele-1: All FHIR elements must have a @value or children
reasonReference | S Σ | 0..* | Reference(De-Identified UDS Plus Diagnosis) | Reason the encounter takes place (reference) ele-1: All FHIR elements must have a @value or children
diagnosis | S Σ | 0..* | BackboneElement | The list of diagnosis relevant to this encounter ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
condition | S Σ | 1..1 | Reference(De-Identified UDS Plus Diagnosis) | The diagnosis or procedure relevant to the encounter ele-1: All FHIR elements must have a @value or children
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. ele-1: All FHIR elements must have a @value or children
rank | S | 0..1 | positiveInt | Ranking of the diagnosis (for each role type) ele-1: All FHIR elements must have a @value or children
hospitalization | S | 0..1 | BackboneElement | Details about the admission to a healthcare service ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
dischargeDisposition | S | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): The set of codes indicating the discharge disposition ele-1: All FHIR elements must have a @value or children
location | S | 0..* | BackboneElement | List of locations where the patient has been ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
location | S | 1..1 | Reference(UDS Plus Location) | Location the encounter takes place ele-1: All FHIR elements must have a @value or children
serviceProvider | S | 0..1 | Reference(US Core Organization Profile) | The organization (facility) responsible for this encounter ele-1: All FHIR elements must have a @value or children
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Encounter.status | required | EncounterStatus `http://hl7.org/fhir/ValueSet/encounter-status|4.0.1` from the FHIR Standard
Encounter.class | extensible | ActEncounterCode `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode`
Encounter.type | extensible | 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.dischargeDisposition | preferred | USCoreDischargeDisposition (a valid code from `http://www.nubc.org/patient-discharge`) `http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Encounter | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Encounter | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
uds-plus-enc-1 | error | Encounter.participant.period | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-enc-1a | error | Encounter.participant.period | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-enc-1b | error | Encounter.participant.period | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-enc-2 | error | Encounter.participant.period | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-enc-2a | error | Encounter.participant.period | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-enc-2b | error | Encounter.participant.period | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-enc-3 | error | Encounter.period | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-enc-3a | error | Encounter.period | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-enc-3b | error | Encounter.period | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-enc-4 | error | Encounter.period | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-enc-4a | error | Encounter.period | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-enc-4b | error | Encounter.period | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |

This structure is derived from Encounter

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Encounter |  | 0..* | Encounter | De-Identified UDS Plus Encounter
id | S | 0..1 | id | The de-identified Encounter identifier created by the health center to send data to UDS+ Data Receiver
text |  | 0..0 |  |
contained |  | 0..0 |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:uds-plus-age-extension | S | 1..1 | Quantity | Age of the Patient computed using birthDate and the visit dates of the encounter URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
status | S | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled +
class | S | 1..1 | Coding | Classification of patient encounter
type | S | 1..* | CodeableConcept | Specific type of encounter Binding: US Core Encounter Type (extensible): The set of codes indicating the type of encounter
subject | S | 1..1 | Reference(De-Identified UDS Plus Patient) | The patient or group present at the encounter
display |  | 0..0 |  |
participant | S | 0..* | BackboneElement | List of participants involved in the encounter
type | S | 0..* | CodeableConcept | Role of participant in encounter
period | S C | 0..1 | Period | Period of time during the encounter that the participant participated uds-plus-enc-1: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-1a: All Period.start data elements should have valid year > 1900 uds-plus-enc-1b: All Period.start data elements should have valid year < 2030 uds-plus-enc-2: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-enc-2a: All Period.end data elements should have valid year > 1900 uds-plus-enc-2b: All Period.end data elements should have valid year < 2030
individual | S | 0..1 | Reference(US Core Practitioner Profile) | Persons involved in the encounter other than the patient
period | S C | 0..1 | Period | The start and end time of the encounter uds-plus-enc-3: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-3a: All Period.start data elements should have valid year > 1900 uds-plus-enc-3b: All Period.start data elements should have valid year < 2030 uds-plus-enc-4: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-enc-4a: All Period.end data elements should have valid year > 1900 uds-plus-enc-4b: All Period.end data elements should have valid year < 2030
reasonCode | S | 0..* | CodeableConcept | Coded reason the encounter takes place
reasonReference | S | 0..* | Reference(De-Identified UDS Plus Diagnosis) | Reason the encounter takes place (reference)
diagnosis | S | 0..* | BackboneElement | The list of diagnosis relevant to this encounter
condition | S | 1..1 | Reference(De-Identified UDS Plus Diagnosis) | 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 …)
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
dischargeDisposition | S | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): The set of codes indicating the discharge disposition
location | S | 0..* | BackboneElement | List of locations where the patient has been
location | S | 1..1 | Reference(UDS Plus Location) | Location the encounter takes place
serviceProvider | S | 0..1 | Reference(US Core Organization Profile) | The organization (facility) responsible for this encounter
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Encounter.type | extensible | USCoreEncounterType `http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type`
Encounter.hospitalization.dischargeDisposition | preferred | USCoreDischargeDisposition (a valid code from `http://www.nubc.org/patient-discharge`) `http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
uds-plus-enc-1 | error | Encounter.participant.period | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-enc-1a | error | Encounter.participant.period | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-enc-1b | error | Encounter.participant.period | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-enc-2 | error | Encounter.participant.period | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-enc-2a | error | Encounter.participant.period | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-enc-2b | error | Encounter.participant.period | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-enc-3 | error | Encounter.period | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-enc-3a | error | Encounter.period | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-enc-3b | error | Encounter.period | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-enc-4 | error | Encounter.period | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-enc-4a | error | Encounter.period | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-enc-4b | error | Encounter.period | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Encounter |  | 0..* | Encounter | De-Identified UDS Plus Encounter
id | S Σ | 0..1 | id | The de-identified Encounter identifier created by the health center to send data to UDS+ Data Receiver
meta | Σ | 0..1 | Meta | Metadata about the resource
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
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:uds-plus-age-extension | S | 1..1 | Quantity | Age of the Patient computed using birthDate and the visit dates of the encounter URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Identifier(s) by which this encounter is known
status | ?!S Σ | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
statusHistory |  | 0..* | BackboneElement | List of past encounter statuses
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
status |  | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified status
class | S Σ | 1..1 | Coding | Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
classHistory |  | 0..* | BackboneElement | List of past encounter classes
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
class |  | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified class
type | S Σ | 1..* | CodeableConcept | Specific type of encounter Binding: US Core Encounter Type (extensible): The set of codes indicating the type of encounter
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 (example): Indicates the urgency of the encounter.
subject | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | 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 | Σ C | 0..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
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 C | 0..1 | Period | Period of time during the encounter that the participant participated uds-plus-enc-1: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-1a: All Period.start data elements should have valid year > 1900 uds-plus-enc-1b: All Period.start data elements should have valid year < 2030 uds-plus-enc-2: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-enc-2a: All Period.end data elements should have valid year > 1900 uds-plus-enc-2b: All Period.end data elements should have valid year < 2030
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 C | 0..1 | Period | The start and end time of the encounter uds-plus-enc-3: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-3a: All Period.start data elements should have valid year > 1900 uds-plus-enc-3b: All Period.start data elements should have valid year < 2030 uds-plus-enc-4: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-enc-4a: All Period.end data elements should have valid year > 1900 uds-plus-enc-4b: All Period.end data elements should have valid year < 2030
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 | S Σ | 0..* | Reference(De-Identified UDS Plus Diagnosis) | 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 | S Σ | 1..1 | Reference(De-Identified UDS Plus Diagnosis) | 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 |  | 0..1 | Reference(Location | Organization) | The location/organization from which the patient came before admission
admitSource |  | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission |  | 0..1 | CodeableConcept | The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference |  | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy |  | 0..* | CodeableConcept | Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement |  | 0..* | CodeableConcept | Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination |  | 0..1 | Reference(Location | Organization) | Location/organization to which the patient is discharged
dischargeDisposition | S | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): The set of codes indicating the discharge disposition
location | S | 0..* | BackboneElement | List of locations where the patient has been
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
location | S | 1..1 | Reference(UDS Plus Location) | Location the encounter takes place
status |  | 0..1 | code | planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType |  | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period |  | 0..1 | Period | Time period during which the patient was present at the location
serviceProvider | S | 0..1 | Reference(US Core Organization Profile) | 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.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Encounter.status | required | EncounterStatus `http://hl7.org/fhir/ValueSet/encounter-status|4.0.1` from the FHIR Standard
Encounter.statusHistory.status | required | EncounterStatus `http://hl7.org/fhir/ValueSet/encounter-status|4.0.1` from the FHIR Standard
Encounter.class | extensible | ActEncounterCode `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode`
Encounter.classHistory.class | extensible | ActEncounterCode `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode`
Encounter.type | extensible | USCoreEncounterType `http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type`
Encounter.serviceType | example | ServiceType `http://hl7.org/fhir/ValueSet/service-type` from the FHIR Standard
Encounter.priority | example | ActPriority `http://terminology.hl7.org/ValueSet/v3-ActPriority`
Encounter.subject.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` 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 | example | Hl7VSReAdmissionIndicator `http://terminology.hl7.org/ValueSet/v2-0092`
Encounter.hospitalization.dietPreference | example | Diet `http://hl7.org/fhir/ValueSet/encounter-diet` from the FHIR Standard
Encounter.hospitalization.specialCourtesy | preferred | SpecialCourtesy `http://hl7.org/fhir/ValueSet/encounter-special-courtesy` from the FHIR Standard
Encounter.hospitalization.specialArrangement | preferred | SpecialArrangements `http://hl7.org/fhir/ValueSet/encounter-special-arrangements` from the FHIR Standard
Encounter.hospitalization.dischargeDisposition | preferred | USCoreDischargeDisposition (a valid code from `http://www.nubc.org/patient-discharge`) `http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition`
Encounter.location.status | required | EncounterLocationStatus `http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1` from the FHIR Standard
Encounter.location.physicalType | example | LocationType `http://hl7.org/fhir/ValueSet/location-physical-type` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Encounter | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Encounter | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
uds-plus-enc-1 | error | Encounter.participant.period | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-enc-1a | error | Encounter.participant.period | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-enc-1b | error | Encounter.participant.period | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-enc-2 | error | Encounter.participant.period | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-enc-2a | error | Encounter.participant.period | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-enc-2b | error | Encounter.participant.period | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-enc-3 | error | Encounter.period | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-enc-3a | error | Encounter.period | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-enc-3b | error | Encounter.period | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-enc-4 | error | Encounter.period | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-enc-4a | error | Encounter.period | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-enc-4b | error | Encounter.period | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |

This structure is derived from Encounter

Summary

Mandatory: 5 elements(2 nested mandatory elements)
Must-Support: 22 elements
Prohibited: 3 elements

Structures

This structure refers to these other structures:

- De-Identified UDS Plus Patient (http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/de-identified-uds-plus-patient)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
- De-Identified UDS Plus Diagnosis (http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-diagnosis)
- UDS Plus Location (http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-location)
- US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Encounter |  | 0..* | Encounter | De-Identified UDS Plus Encounter dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
id | S Σ | 0..1 | id | The de-identified Encounter identifier created by the health center to send data to UDS+ Data Receiver
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:uds-plus-age-extension | S | 1..1 | Quantity | Age of the Patient computed using birthDate and the visit dates of the encounter URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status | ?!S Σ | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. ele-1: All FHIR elements must have a @value or children
class | S Σ | 1..1 | Coding | Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter. ele-1: All FHIR elements must have a @value or children
type | S Σ | 1..* | CodeableConcept | Specific type of encounter Binding: US Core Encounter Type (extensible): The set of codes indicating the type of encounter ele-1: All FHIR elements must have a @value or children
subject | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | The patient or group present at the encounter ele-1: All FHIR elements must have a @value or children
participant | S Σ | 0..* | BackboneElement | List of participants involved in the encounter ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type | S Σ | 0..* | CodeableConcept | Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter. ele-1: All FHIR elements must have a @value or children
period | S C | 0..1 | Period | Period of time during the encounter that the participant participated ele-1: All FHIR elements must have a @value or children uds-plus-enc-1: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-1a: All Period.start data elements should have valid year > 1900 uds-plus-enc-1b: All Period.start data elements should have valid year < 2030 uds-plus-enc-2: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-enc-2a: All Period.end data elements should have valid year > 1900 uds-plus-enc-2b: All Period.end data elements should have valid year < 2030
individual | S Σ | 0..1 | Reference(US Core Practitioner Profile) | Persons involved in the encounter other than the patient ele-1: All FHIR elements must have a @value or children
period | S C | 0..1 | Period | The start and end time of the encounter ele-1: All FHIR elements must have a @value or children uds-plus-enc-3: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-3a: All Period.start data elements should have valid year > 1900 uds-plus-enc-3b: All Period.start data elements should have valid year < 2030 uds-plus-enc-4: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-enc-4a: All Period.end data elements should have valid year > 1900 uds-plus-enc-4b: All Period.end data elements should have valid year < 2030
reasonCode | S Σ | 0..* | CodeableConcept | Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place. ele-1: All FHIR elements must have a @value or children
reasonReference | S Σ | 0..* | Reference(De-Identified UDS Plus Diagnosis) | Reason the encounter takes place (reference) ele-1: All FHIR elements must have a @value or children
diagnosis | S Σ | 0..* | BackboneElement | The list of diagnosis relevant to this encounter ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
condition | S Σ | 1..1 | Reference(De-Identified UDS Plus Diagnosis) | The diagnosis or procedure relevant to the encounter ele-1: All FHIR elements must have a @value or children
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. ele-1: All FHIR elements must have a @value or children
rank | S | 0..1 | positiveInt | Ranking of the diagnosis (for each role type) ele-1: All FHIR elements must have a @value or children
hospitalization | S | 0..1 | BackboneElement | Details about the admission to a healthcare service ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
dischargeDisposition | S | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): The set of codes indicating the discharge disposition ele-1: All FHIR elements must have a @value or children
location | S | 0..* | BackboneElement | List of locations where the patient has been ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
location | S | 1..1 | Reference(UDS Plus Location) | Location the encounter takes place ele-1: All FHIR elements must have a @value or children
serviceProvider | S | 0..1 | Reference(US Core Organization Profile) | The organization (facility) responsible for this encounter ele-1: All FHIR elements must have a @value or children
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Encounter.status | required | EncounterStatus `http://hl7.org/fhir/ValueSet/encounter-status|4.0.1` from the FHIR Standard
Encounter.class | extensible | ActEncounterCode `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode`
Encounter.type | extensible | 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.dischargeDisposition | preferred | USCoreDischargeDisposition (a valid code from `http://www.nubc.org/patient-discharge`) `http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Encounter | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Encounter | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
uds-plus-enc-1 | error | Encounter.participant.period | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-enc-1a | error | Encounter.participant.period | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-enc-1b | error | Encounter.participant.period | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-enc-2 | error | Encounter.participant.period | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-enc-2a | error | Encounter.participant.period | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-enc-2b | error | Encounter.participant.period | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-enc-3 | error | Encounter.period | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-enc-3a | error | Encounter.period | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-enc-3b | error | Encounter.period | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-enc-4 | error | Encounter.period | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-enc-4a | error | Encounter.period | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-enc-4b | error | Encounter.period | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |

Differential View

This structure is derived from Encounter

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Encounter |  | 0..* | Encounter | De-Identified UDS Plus Encounter
id | S | 0..1 | id | The de-identified Encounter identifier created by the health center to send data to UDS+ Data Receiver
text |  | 0..0 |  |
contained |  | 0..0 |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:uds-plus-age-extension | S | 1..1 | Quantity | Age of the Patient computed using birthDate and the visit dates of the encounter URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
status | S | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled +
class | S | 1..1 | Coding | Classification of patient encounter
type | S | 1..* | CodeableConcept | Specific type of encounter Binding: US Core Encounter Type (extensible): The set of codes indicating the type of encounter
subject | S | 1..1 | Reference(De-Identified UDS Plus Patient) | The patient or group present at the encounter
display |  | 0..0 |  |
participant | S | 0..* | BackboneElement | List of participants involved in the encounter
type | S | 0..* | CodeableConcept | Role of participant in encounter
period | S C | 0..1 | Period | Period of time during the encounter that the participant participated uds-plus-enc-1: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-1a: All Period.start data elements should have valid year > 1900 uds-plus-enc-1b: All Period.start data elements should have valid year < 2030 uds-plus-enc-2: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-enc-2a: All Period.end data elements should have valid year > 1900 uds-plus-enc-2b: All Period.end data elements should have valid year < 2030
individual | S | 0..1 | Reference(US Core Practitioner Profile) | Persons involved in the encounter other than the patient
period | S C | 0..1 | Period | The start and end time of the encounter uds-plus-enc-3: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-3a: All Period.start data elements should have valid year > 1900 uds-plus-enc-3b: All Period.start data elements should have valid year < 2030 uds-plus-enc-4: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-enc-4a: All Period.end data elements should have valid year > 1900 uds-plus-enc-4b: All Period.end data elements should have valid year < 2030
reasonCode | S | 0..* | CodeableConcept | Coded reason the encounter takes place
reasonReference | S | 0..* | Reference(De-Identified UDS Plus Diagnosis) | Reason the encounter takes place (reference)
diagnosis | S | 0..* | BackboneElement | The list of diagnosis relevant to this encounter
condition | S | 1..1 | Reference(De-Identified UDS Plus Diagnosis) | 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 …)
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
dischargeDisposition | S | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): The set of codes indicating the discharge disposition
location | S | 0..* | BackboneElement | List of locations where the patient has been
location | S | 1..1 | Reference(UDS Plus Location) | Location the encounter takes place
serviceProvider | S | 0..1 | Reference(US Core Organization Profile) | The organization (facility) responsible for this encounter
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Encounter.type | extensible | USCoreEncounterType `http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type`
Encounter.hospitalization.dischargeDisposition | preferred | USCoreDischargeDisposition (a valid code from `http://www.nubc.org/patient-discharge`) `http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
uds-plus-enc-1 | error | Encounter.participant.period | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-enc-1a | error | Encounter.participant.period | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-enc-1b | error | Encounter.participant.period | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-enc-2 | error | Encounter.participant.period | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-enc-2a | error | Encounter.participant.period | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-enc-2b | error | Encounter.participant.period | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-enc-3 | error | Encounter.period | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-enc-3a | error | Encounter.period | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-enc-3b | error | Encounter.period | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-enc-4 | error | Encounter.period | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-enc-4a | error | Encounter.period | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-enc-4b | error | Encounter.period | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Encounter |  | 0..* | Encounter | De-Identified UDS Plus Encounter
id | S Σ | 0..1 | id | The de-identified Encounter identifier created by the health center to send data to UDS+ Data Receiver
meta | Σ | 0..1 | Meta | Metadata about the resource
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
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:uds-plus-age-extension | S | 1..1 | Quantity | Age of the Patient computed using birthDate and the visit dates of the encounter URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Identifier(s) by which this encounter is known
status | ?!S Σ | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
statusHistory |  | 0..* | BackboneElement | List of past encounter statuses
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
status |  | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified status
class | S Σ | 1..1 | Coding | Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
classHistory |  | 0..* | BackboneElement | List of past encounter classes
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
class |  | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified class
type | S Σ | 1..* | CodeableConcept | Specific type of encounter Binding: US Core Encounter Type (extensible): The set of codes indicating the type of encounter
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 (example): Indicates the urgency of the encounter.
subject | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | 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 | Σ C | 0..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
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 C | 0..1 | Period | Period of time during the encounter that the participant participated uds-plus-enc-1: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-1a: All Period.start data elements should have valid year > 1900 uds-plus-enc-1b: All Period.start data elements should have valid year < 2030 uds-plus-enc-2: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-enc-2a: All Period.end data elements should have valid year > 1900 uds-plus-enc-2b: All Period.end data elements should have valid year < 2030
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 C | 0..1 | Period | The start and end time of the encounter uds-plus-enc-3: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-3a: All Period.start data elements should have valid year > 1900 uds-plus-enc-3b: All Period.start data elements should have valid year < 2030 uds-plus-enc-4: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-enc-4a: All Period.end data elements should have valid year > 1900 uds-plus-enc-4b: All Period.end data elements should have valid year < 2030
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 | S Σ | 0..* | Reference(De-Identified UDS Plus Diagnosis) | 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 | S Σ | 1..1 | Reference(De-Identified UDS Plus Diagnosis) | 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 |  | 0..1 | Reference(Location | Organization) | The location/organization from which the patient came before admission
admitSource |  | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission |  | 0..1 | CodeableConcept | The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference |  | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy |  | 0..* | CodeableConcept | Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement |  | 0..* | CodeableConcept | Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination |  | 0..1 | Reference(Location | Organization) | Location/organization to which the patient is discharged
dischargeDisposition | S | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): The set of codes indicating the discharge disposition
location | S | 0..* | BackboneElement | List of locations where the patient has been
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
location | S | 1..1 | Reference(UDS Plus Location) | Location the encounter takes place
status |  | 0..1 | code | planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType |  | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period |  | 0..1 | Period | Time period during which the patient was present at the location
serviceProvider | S | 0..1 | Reference(US Core Organization Profile) | 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.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Encounter.status | required | EncounterStatus `http://hl7.org/fhir/ValueSet/encounter-status|4.0.1` from the FHIR Standard
Encounter.statusHistory.status | required | EncounterStatus `http://hl7.org/fhir/ValueSet/encounter-status|4.0.1` from the FHIR Standard
Encounter.class | extensible | ActEncounterCode `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode`
Encounter.classHistory.class | extensible | ActEncounterCode `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode`
Encounter.type | extensible | USCoreEncounterType `http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type`
Encounter.serviceType | example | ServiceType `http://hl7.org/fhir/ValueSet/service-type` from the FHIR Standard
Encounter.priority | example | ActPriority `http://terminology.hl7.org/ValueSet/v3-ActPriority`
Encounter.subject.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` 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 | example | Hl7VSReAdmissionIndicator `http://terminology.hl7.org/ValueSet/v2-0092`
Encounter.hospitalization.dietPreference | example | Diet `http://hl7.org/fhir/ValueSet/encounter-diet` from the FHIR Standard
Encounter.hospitalization.specialCourtesy | preferred | SpecialCourtesy `http://hl7.org/fhir/ValueSet/encounter-special-courtesy` from the FHIR Standard
Encounter.hospitalization.specialArrangement | preferred | SpecialArrangements `http://hl7.org/fhir/ValueSet/encounter-special-arrangements` from the FHIR Standard
Encounter.hospitalization.dischargeDisposition | preferred | USCoreDischargeDisposition (a valid code from `http://www.nubc.org/patient-discharge`) `http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition`
Encounter.location.status | required | EncounterLocationStatus `http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1` from the FHIR Standard
Encounter.location.physicalType | example | LocationType `http://hl7.org/fhir/ValueSet/location-physical-type` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Encounter | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Encounter | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
uds-plus-enc-1 | error | Encounter.participant.period | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-enc-1a | error | Encounter.participant.period | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-enc-1b | error | Encounter.participant.period | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-enc-2 | error | Encounter.participant.period | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-enc-2a | error | Encounter.participant.period | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-enc-2b | error | Encounter.participant.period | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |
uds-plus-enc-3 | error | Encounter.period | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4 |
uds-plus-enc-3a | error | Encounter.period | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' |
uds-plus-enc-3b | error | Encounter.period | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' |
uds-plus-enc-4 | error | Encounter.period | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4 |
uds-plus-enc-4a | error | Encounter.period | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' |
uds-plus-enc-4b | error | Encounter.period | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' |

This structure is derived from Encounter

Summary

Mandatory: 5 elements(2 nested mandatory elements)
Must-Support: 22 elements
Prohibited: 3 elements

Structures

This structure refers to these other structures:

- De-Identified UDS Plus Patient (http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/de-identified-uds-plus-patient)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
- De-Identified UDS Plus Diagnosis (http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-diagnosis)
- UDS Plus Location (http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-location)
- US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension

Maturity: 2

Other representations of profile: CSV, Excel, Schematron