eHealth Infrastructure (v2020.6.1)

StructureDefinition: ehealth-episodeofcare - Detailed Descriptions

Definitions for the ehealth-episodeofcare Profile.

1. EpisodeOfCare
Definition

An association between a patient and an organization / healthcare provider(s) during which time encounters may occur. The managing organization assumes a level of responsibility for the patient during this time.

Control0..*
Alternate NamesCase Program Problem
InvariantsDefined on this element
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (: contained.where(('#'+id in %resource.descendants().reference).not()).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
2. EpisodeOfCare.id
Definition

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

Control0..1
Typeid
Comments

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

3. EpisodeOfCare.meta
Definition

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

Control0..1
TypeMeta
4. EpisodeOfCare.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

Control0..1
Typeuri
Is Modifiertrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

5. EpisodeOfCare.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Max Binding: All Languages
Typecode
Comments

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

6. EpisodeOfCare.text
Definition

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

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

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

7. EpisodeOfCare.contained
Definition

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

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

8. EpisodeOfCare.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices on EpisodeOfCare.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
9. EpisodeOfCare.extension:caremanagerOrganization
SliceNamecaremanagerOrganization
Definition

An Extension

Control1..1 This element is affected by the following invariants: ele-1
TypeExtension(caremanagerOrganization) (Extension Type: Reference)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. EpisodeOfCare.extension:teamHistory
SliceNameteamHistory
Definition

An Extension

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(teamHistory) (Extension Type: Choice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
11. EpisodeOfCare.extension:statusSchedule
SliceNamestatusSchedule
Definition

Contains a list of scheduled status changes

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(episodeofcare-statusschedule) (Extension Type: Choice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
12. EpisodeOfCare.extension:teamSchedule
SliceNameteamSchedule
Definition

Contains a list of scheduled team changes

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(teamschedule) (Extension Type: Choice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
13. EpisodeOfCare.modifierExtension
Definition

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

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
Comments

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

14. EpisodeOfCare.identifier
Definition

The EpisodeOfCare may be known by different identifiers for different contexts of use, such as when an external agency is tracking the Episode for funding purposes.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
15. EpisodeOfCare.status
Definition

planned | waitlist | active | onhold | finished | cancelled.

Control1..1
BindingThe status of the episode of care.
The codes SHALL be taken from EpisodeOfCareStatus
Typecode
Is Modifiertrue
Comments

This element is labeled as a modifier because the status contains codes that mark the episode as not currently valid.

16. EpisodeOfCare.statusHistory
Definition

The history of statuses that the EpisodeOfCare has been through (without requiring processing the history of the resource).

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
17. EpisodeOfCare.statusHistory.id
Definition

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

Control0..1
Typestring
18. EpisodeOfCare.statusHistory.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

19. EpisodeOfCare.statusHistory.modifierExtension
Definition

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

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

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

20. EpisodeOfCare.statusHistory.status
Definition

planned | waitlist | active | onhold | finished | cancelled.

Control1..1
BindingThe status of the episode of care.
The codes SHALL be taken from EpisodeOfCareStatus
Typecode
21. EpisodeOfCare.statusHistory.period
Definition

The period during this EpisodeOfCare that the specific status applied.

Control1..1
TypePeriod
22. EpisodeOfCare.type
Definition

A classification of the type of episode of care; e.g. specialist referral, disease management, type of funded care.

Control0..*
BindingThe type of the episode of care
For example codes, see EpisodeOfCareType
TypeCodeableConcept
Comments

The type can be very important in processing as this could be used in determining if the EpisodeOfCare is relevant to specific government reporting, or other types of classifications.

23. EpisodeOfCare.diagnosis
Definition

The list of diagnosis relevant to this episode of care.

Control1..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
24. EpisodeOfCare.diagnosis.id
Definition

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

Control0..1
Typestring
25. EpisodeOfCare.diagnosis.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

26. EpisodeOfCare.diagnosis.modifierExtension
Definition

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

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

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

27. EpisodeOfCare.diagnosis.condition
Definition

A list of conditions/problems/diagnoses that this episode of care is intended to be providing care for.

Control1..1
TypeReference(ehealth-condition)
28. EpisodeOfCare.diagnosis.role
Definition

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

Control0..1
BindingThe type of diagnosis this condition represents
The codes SHOULD be taken from DiagnosisRole
TypeCodeableConcept
29. EpisodeOfCare.diagnosis.rank
Definition

Ranking of the diagnosis (for each role type).

Control0..1
TypepositiveInt
30. EpisodeOfCare.patient
Definition

The patient who is the focus of this episode of care.

Control1..1
TypeReference(ehealth-patient)
31. EpisodeOfCare.managingOrganization
Definition

The organization that has assumed the specific responsibilities for the specified duration.

Control1..1
TypeReference(ehealth-organization)
32. EpisodeOfCare.period
Definition

The interval during which the managing organization assumes the defined responsibility.

Control1..1
TypePeriod
33. EpisodeOfCare.referralRequest
Definition

Referral Request(s) that are fulfilled by this EpisodeOfCare, incoming referrals.

Control0..*
TypeReference(ReferralRequest)
34. EpisodeOfCare.careManager
Definition

The practitioner that is the care manager/care co-ordinator for this patient.

Control0..0
TypeReference(Practitioner)
35. EpisodeOfCare.team
Definition

The list of practitioners that may be facilitating this episode of care for specific purposes.

Control0..*
TypeReference(ehealth-careteam)
Alternate NamesCareTeam
36. EpisodeOfCare.account
Definition

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

Control0..0
TypeReference(Account)
Comments

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