eHealth Infrastructure (v2019.5.3)

StructureDefinition: ehealth-episodeofcare

Introduction

An EpisodeOfCare is an association between a patient and an organization / healthcare provider(s) during which time encounters may occur.

Scope and Usage

In scope of the eHealth infrastructure, creation of an EpisodeOfCare resource is triggered by a number of actions taking place out-of-band, that is, outside the scope of the eHealth infrastructure. Firstly, a patient is diagnosed with one or more conditions; then assessed as fulfilling criteria for enrollment in a telemedical care program leading to a referral being made to an organization providing such program. At this point a Practitioner within the providing organization creates an EpisodeOfCare referring to the Patient and the corresponding Conditions, all in the eHealth infrastructure. Created with status draft, the Practitioner updates the status to active once:

  • a Consent to enroll in the program has been given by the Patient
  • responsibilities have been assigned to Practitioner and/or CareTeam

The EpisodeOfCare functions as a representation of a program while the activities comprising it are defined in one or more CarePlan resources.

careManagers and careManagerHistory

An EpisodeOfCare is required to have at least one care manager (Danish: “Behandlingsansvarlig”) at any time. The careManagers element states who is the current care manager.

Historical care managers are referenced from the careManagerHistory element together with the period during which they were current.

Responsible and responsibleHistory

An EpisodeOfCare can have a number of responsible CareTeams, Practitioners or Organizations with different roles who are responsible for monitoring different aspects of the EpisodeOfCare. For instance a Practitioner could have the role of “monitoringResponsible”. All responsibles referenced from element responsible currently hold the responsibility defined by their role.

Historically responsible CareTeams, Practitioners or Organizations are referenced from element responsibleHistory. This structure is identical to values of the responsible element except that entries in responsibleHistory also carry a “period” which states the period during which the referenced party was responsible for the EpisodeOfCare.

Formal Views of Profile Content

The official URL for this profile is: 

http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-episodeofcare

This profile builds on EpisodeOfCare.

This profile was published on Fri Jun 07 11:10:06 UTC 2019 as a draft by ehealth.sundhed.dk.

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

This structure is derived from EpisodeOfCare

NameFlagsCard.TypeDescription & Constraintsdoco
.. EpisodeOfCare 0..*An association between a patient and an organization / healthcare provider(s) during which time encounters may occur.
... extension 0..*ExtensionSlice: Unordered, Open by value:url
... ehealth-episodeofcare-careManagers 1..*Reference(eHealth Practitioner | eHealth CareTeam | eHealth Organization) {r}Care managers/care coordinators.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-episodeofcare-careManagers
... ehealth-episodeofcare-careManagerHistory 0..*(Complex)History of care managers/care coordinators for the patient.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-episodeofcare-careManagerHistory
... ehealth-responsible 0..*(Complex)Individuals, careteam or organization responsible for monitoring this plan.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-responsible
... ehealth-responsibleHistory 0..*(Complex)Previous individuals, careteams and organizations responsible for monitoring this plan.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-responsibleHistory
... diagnosis 1..*BackboneElement
.... condition 1..1Reference(eHealth Condition) {r}
... patient 1..1Reference(eHealth Patient) {r}
... managingOrganization 1..1Reference(eHealth Organization) {r}
... period 1..1Period
... referralRequest 0..*Reference(ReferralRequest) {r}
... careManager 0..0
... team 0..*Reference(eHealth CareTeam) {r}
... account 0..0

doco Documentation for this format

This structure is derived from EpisodeOfCare

NameFlagsCard.TypeDescription & Constraintsdoco
.. EpisodeOfCare I0..*An association between a patient and an organization / healthcare provider(s) during which time encounters may occur.
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... ehealth-episodeofcare-careManagers 1..*Reference(eHealth Practitioner | eHealth CareTeam | eHealth Organization) {r}Care managers/care coordinators.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-episodeofcare-careManagers
... ehealth-episodeofcare-careManagerHistory 0..*(Complex)History of care managers/care coordinators for the patient.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-episodeofcare-careManagerHistory
... ehealth-responsible 0..*(Complex)Individuals, careteam or organization responsible for monitoring this plan.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-responsible
... ehealth-responsibleHistory 0..*(Complex)Previous individuals, careteams and organizations responsible for monitoring this plan.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-responsibleHistory
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierBusiness Identifier(s) relevant for this EpisodeOfCare
... status ?!Σ1..1codeplanned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
... statusHistory I0..*BackboneElementPast list of status codes (the current status may be included to cover the start date of the status)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... status 1..1codeplanned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
.... period 1..1PeriodDuration the EpisodeOfCare was in the specified status
... type Σ0..*CodeableConceptType/class - e.g. specialist referral, disease management
Binding: EpisodeOfCareType (example)
... diagnosis ΣI1..*BackboneElementThe list of diagnosis relevant to this episode of care
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... condition Σ1..1Reference(eHealth Condition) {r}Conditions/problems/diagnoses this episode of care is for
.... role Σ0..1CodeableConceptRole that this diagnosis has within the episode of care (e.g. admission, billing, discharge …)
Binding: DiagnosisRole (preferred)
.... rank Σ0..1positiveIntRanking of the diagnosis (for each role type)
... patient Σ1..1Reference(eHealth Patient) {r}The patient who is the focus of this episode of care
... managingOrganization Σ1..1Reference(eHealth Organization) {r}Organization that assumes care
... period Σ1..1PeriodInterval during responsibility is assumed
... referralRequest 0..*Reference(ReferralRequest) {r}Originating Referral Request(s)
... team 0..*Reference(eHealth CareTeam) {r}Other practitioners facilitating this episode of care

doco Documentation for this format

Differential View

This structure is derived from EpisodeOfCare

NameFlagsCard.TypeDescription & Constraintsdoco
.. EpisodeOfCare 0..*An association between a patient and an organization / healthcare provider(s) during which time encounters may occur.
... extension 0..*ExtensionSlice: Unordered, Open by value:url
... ehealth-episodeofcare-careManagers 1..*Reference(eHealth Practitioner | eHealth CareTeam | eHealth Organization) {r}Care managers/care coordinators.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-episodeofcare-careManagers
... ehealth-episodeofcare-careManagerHistory 0..*(Complex)History of care managers/care coordinators for the patient.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-episodeofcare-careManagerHistory
... ehealth-responsible 0..*(Complex)Individuals, careteam or organization responsible for monitoring this plan.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-responsible
... ehealth-responsibleHistory 0..*(Complex)Previous individuals, careteams and organizations responsible for monitoring this plan.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-responsibleHistory
... diagnosis 1..*BackboneElement
.... condition 1..1Reference(eHealth Condition) {r}
... patient 1..1Reference(eHealth Patient) {r}
... managingOrganization 1..1Reference(eHealth Organization) {r}
... period 1..1Period
... referralRequest 0..*Reference(ReferralRequest) {r}
... careManager 0..0
... team 0..*Reference(eHealth CareTeam) {r}
... account 0..0

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. EpisodeOfCare I0..*An association between a patient and an organization / healthcare provider(s) during which time encounters may occur.
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... ehealth-episodeofcare-careManagers 1..*Reference(eHealth Practitioner | eHealth CareTeam | eHealth Organization) {r}Care managers/care coordinators.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-episodeofcare-careManagers
... ehealth-episodeofcare-careManagerHistory 0..*(Complex)History of care managers/care coordinators for the patient.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-episodeofcare-careManagerHistory
... ehealth-responsible 0..*(Complex)Individuals, careteam or organization responsible for monitoring this plan.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-responsible
... ehealth-responsibleHistory 0..*(Complex)Previous individuals, careteams and organizations responsible for monitoring this plan.
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-responsibleHistory
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierBusiness Identifier(s) relevant for this EpisodeOfCare
... status ?!Σ1..1codeplanned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
... statusHistory I0..*BackboneElementPast list of status codes (the current status may be included to cover the start date of the status)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... status 1..1codeplanned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
.... period 1..1PeriodDuration the EpisodeOfCare was in the specified status
... type Σ0..*CodeableConceptType/class - e.g. specialist referral, disease management
Binding: EpisodeOfCareType (example)
... diagnosis ΣI1..*BackboneElementThe list of diagnosis relevant to this episode of care
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... condition Σ1..1Reference(eHealth Condition) {r}Conditions/problems/diagnoses this episode of care is for
.... role Σ0..1CodeableConceptRole that this diagnosis has within the episode of care (e.g. admission, billing, discharge …)
Binding: DiagnosisRole (preferred)
.... rank Σ0..1positiveIntRanking of the diagnosis (for each role type)
... patient Σ1..1Reference(eHealth Patient) {r}The patient who is the focus of this episode of care
... managingOrganization Σ1..1Reference(eHealth Organization) {r}Organization that assumes care
... period Σ1..1PeriodInterval during responsibility is assumed
... referralRequest 0..*Reference(ReferralRequest) {r}Originating Referral Request(s)
... team 0..*Reference(eHealth CareTeam) {r}Other practitioners facilitating this episode of care

doco Documentation for this format

 

Terminology Bindings

PathNameConformanceValueSet
EpisodeOfCare.languageCommon LanguagesextensibleCommon Languages
EpisodeOfCare.statusEpisodeOfCareStatusrequiredEpisodeOfCareStatus
EpisodeOfCare.statusHistory.statusEpisodeOfCareStatusrequiredEpisodeOfCareStatus
EpisodeOfCare.typeEpisodeOfCareTypeexampleEpisodeOfCareType
EpisodeOfCare.diagnosis.roleDiagnosisRolepreferredDiagnosisRole

Constraints

IdPathDetailsRequirements
dom-2EpisodeOfCareIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-1EpisodeOfCareIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-4EpisodeOfCareIf 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-3EpisodeOfCareIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
ele-1EpisodeOfCare.statusHistoryAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ele-1EpisodeOfCare.diagnosisAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
.