Kenya eClaims FHIR Implementation Guide
0.1.0 - ci-build KE

Kenya eClaims FHIR Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: eClaims Episode of Care Profile

Official URL: https://fhir.dha.go.ke/eclaims/StructureDefinition/ke-eclaims-episodeofcare Version: 0.1.0
Draft as of 2026-05-19 Computable Name: EClaimsEpisodeOfCare

This profile defines constraints on the EpisodeOfCare resource for use within the Kenya eClaims Implementation Guide. It groups a set of related encounters and activities for a patient within a specific care program.

Usages:

  • This Profile is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. EpisodeOfCare 0..* EpisodeOfCare An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... status S 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
.... period S 1..1 Period Duration the EpisodeOfCare was in the specified status
... type SΣ 1..1 CodeableConcept Type/class - e.g. specialist referral, disease management
Binding: Episode of Care Type ValueSet (required)
.... coding SΣ 1..* Coding Code defined by a terminology system
..... system SΣ 1..1 uri Identity of the terminology system
..... code SΣ 1..1 code Symbol in syntax defined by the system
..... display SΣ 1..1 string Representation defined by the system
.... text SΣ 0..1 string Plain text representation of the concept
... diagnosis SΣ 0..* BackboneElement The list of diagnosis relevant to this episode of care
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... condition SΣ 1..1 Reference(Condition) Conditions/problems/diagnoses this episode of care is for
.... role SΣ 0..1 CodeableConcept Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …)
Binding: DiagnosisRole (required)
..... coding SΣ 1..* Coding Code defined by a terminology system
...... system SΣ 1..1 uri Identity of the terminology system
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
..... text SΣ 0..1 string Plain text representation of the concept
... patient SΣ 1..1 Reference(eClaims Patient Profile) The patient who is the focus of this episode of care
... managingOrganization SΣ 1..1 Reference(eClaims Organization Profile) Organization that assumes care
... period SΣ 1..1 Period Interval during responsibility is assumed
.... start SΣC 1..1 dateTime Starting time with inclusive boundary
... referralRequest S 0..* Reference(ServiceRequest) Originating Referral Request(s)
... careManager S 0..1 Reference(Practitioner | PractitionerRole) Care manager/care coordinator for the patient
... team S 0..* Reference(CareTeam) Other practitioners facilitating this episode of care

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
EpisodeOfCare.status Base required EpisodeOfCareStatus 📦4.0.1 FHIR Std.
EpisodeOfCare.statusHistory.​status Base required EpisodeOfCareStatus 📦4.0.1 FHIR Std.
EpisodeOfCare.type Base required Episode of Care Type ValueSet 📦0.1.0 This IG
EpisodeOfCare.diagnosis.​role Base required DiagnosisRole 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error EpisodeOfCare If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error EpisodeOfCare 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 EpisodeOfCare 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 EpisodeOfCare If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice EpisodeOfCare 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()

This structure is derived from EpisodeOfCare

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. EpisodeOfCare 0..* EpisodeOfCare An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
... status S 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
... statusHistory S 0..* BackboneElement Past list of status codes (the current status may be included to cover the start date of the status)
.... status S 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
.... period S 1..1 Period Duration the EpisodeOfCare was in the specified status
... type S 1..1 CodeableConcept Type/class - e.g. specialist referral, disease management
Binding: Episode of Care Type ValueSet (required)
.... coding S 1..* Coding Code defined by a terminology system
..... system S 1..1 uri Identity of the terminology system
..... code S 1..1 code Symbol in syntax defined by the system
..... display S 1..1 string Representation defined by the system
.... text S 0..1 string Plain text representation of the concept
.... condition S 1..1 Reference(Condition) Conditions/problems/diagnoses this episode of care is for
.... role S 0..1 CodeableConcept Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …)
Binding: DiagnosisRole (required)
..... coding S 1..* Coding Code defined by a terminology system
...... system S 1..1 uri Identity of the terminology system
...... code S 1..1 code Symbol in syntax defined by the system
...... display S 1..1 string Representation defined by the system
..... text S 0..1 string Plain text representation of the concept
... patient S 1..1 Reference(eClaims Patient Profile) The patient who is the focus of this episode of care
... managingOrganization S 1..1 Reference(eClaims Organization Profile) Organization that assumes care
... period S 1..1 Period Interval during responsibility is assumed
.... start S 1..1 dateTime Starting time with inclusive boundary
... referralRequest S 0..* Reference(ServiceRequest) Originating Referral Request(s)
... careManager S 0..1 Reference(Practitioner | PractitionerRole) Care manager/care coordinator for the patient
... team S 0..* Reference(CareTeam) Other practitioners facilitating this episode of care

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
EpisodeOfCare.status Base required EpisodeOfCareStatus 📦4.0.1 FHIR Std.
EpisodeOfCare.statusHistory.​status Base required EpisodeOfCareStatus 📦4.0.1 FHIR Std.
EpisodeOfCare.type Base required Episode of Care Type ValueSet 📦0.1.0 This IG
EpisodeOfCare.diagnosis.​role Base required DiagnosisRole 📦4.0.1 FHIR Std.
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. EpisodeOfCare 0..* EpisodeOfCare An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier Business Identifier(s) relevant for this EpisodeOfCare
... status ?!SΣ 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
... statusHistory S 0..* BackboneElement Past list of status codes (the current status may be included to cover the start date of the status)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... status S 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
.... period S 1..1 Period Duration the EpisodeOfCare was in the specified status
... type SΣ 1..1 CodeableConcept Type/class - e.g. specialist referral, disease management
Binding: Episode of Care Type ValueSet (required)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding SΣ 1..* Coding Code defined by a terminology system
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system SΣ 1..1 uri Identity of the terminology system
..... version Σ 0..1 string Version of the system - if relevant
..... code SΣ 1..1 code Symbol in syntax defined by the system
..... display SΣ 1..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text SΣ 0..1 string Plain text representation of the concept
... diagnosis SΣ 0..* BackboneElement The list of diagnosis relevant to this episode of care
.... 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 SΣ 1..1 Reference(Condition) Conditions/problems/diagnoses this episode of care is for
.... role SΣ 0..1 CodeableConcept Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …)
Binding: DiagnosisRole (required)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ 1..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text SΣ 0..1 string Plain text representation of the concept
.... rank Σ 0..1 positiveInt Ranking of the diagnosis (for each role type)
... patient SΣ 1..1 Reference(eClaims Patient Profile) The patient who is the focus of this episode of care
... managingOrganization SΣ 1..1 Reference(eClaims Organization Profile) Organization that assumes care
... period SΣ 1..1 Period Interval during responsibility is assumed
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... start SΣC 1..1 dateTime Starting time with inclusive boundary
.... end ΣC 0..1 dateTime End time with inclusive boundary, if not ongoing
... referralRequest S 0..* Reference(ServiceRequest) Originating Referral Request(s)
... careManager S 0..1 Reference(Practitioner | PractitionerRole) Care manager/care coordinator for the patient
... team S 0..* Reference(CareTeam) Other practitioners facilitating this episode of care
... account 0..* Reference(Account) The set of accounts that may be used for billing for this EpisodeOfCare

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
EpisodeOfCare.language Base preferred Common Languages 📍4.0.1 FHIR Std.
EpisodeOfCare.status Base required EpisodeOfCareStatus 📦4.0.1 FHIR Std.
EpisodeOfCare.statusHistory.​status Base required EpisodeOfCareStatus 📦4.0.1 FHIR Std.
EpisodeOfCare.type Base required Episode of Care Type ValueSet 📦0.1.0 This IG
EpisodeOfCare.diagnosis.​role Base required DiagnosisRole 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error EpisodeOfCare If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error EpisodeOfCare 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 EpisodeOfCare 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 EpisodeOfCare If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice EpisodeOfCare 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()

This structure is derived from EpisodeOfCare

Summary

Mandatory: 8 elements(4 nested mandatory elements)
Must-Support: 25 elements

Structures

This structure refers to these other structures:

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. EpisodeOfCare 0..* EpisodeOfCare An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... status S 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
.... period S 1..1 Period Duration the EpisodeOfCare was in the specified status
... type SΣ 1..1 CodeableConcept Type/class - e.g. specialist referral, disease management
Binding: Episode of Care Type ValueSet (required)
.... coding SΣ 1..* Coding Code defined by a terminology system
..... system SΣ 1..1 uri Identity of the terminology system
..... code SΣ 1..1 code Symbol in syntax defined by the system
..... display SΣ 1..1 string Representation defined by the system
.... text SΣ 0..1 string Plain text representation of the concept
... diagnosis SΣ 0..* BackboneElement The list of diagnosis relevant to this episode of care
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... condition SΣ 1..1 Reference(Condition) Conditions/problems/diagnoses this episode of care is for
.... role SΣ 0..1 CodeableConcept Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …)
Binding: DiagnosisRole (required)
..... coding SΣ 1..* Coding Code defined by a terminology system
...... system SΣ 1..1 uri Identity of the terminology system
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
..... text SΣ 0..1 string Plain text representation of the concept
... patient SΣ 1..1 Reference(eClaims Patient Profile) The patient who is the focus of this episode of care
... managingOrganization SΣ 1..1 Reference(eClaims Organization Profile) Organization that assumes care
... period SΣ 1..1 Period Interval during responsibility is assumed
.... start SΣC 1..1 dateTime Starting time with inclusive boundary
... referralRequest S 0..* Reference(ServiceRequest) Originating Referral Request(s)
... careManager S 0..1 Reference(Practitioner | PractitionerRole) Care manager/care coordinator for the patient
... team S 0..* Reference(CareTeam) Other practitioners facilitating this episode of care

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
EpisodeOfCare.status Base required EpisodeOfCareStatus 📦4.0.1 FHIR Std.
EpisodeOfCare.statusHistory.​status Base required EpisodeOfCareStatus 📦4.0.1 FHIR Std.
EpisodeOfCare.type Base required Episode of Care Type ValueSet 📦0.1.0 This IG
EpisodeOfCare.diagnosis.​role Base required DiagnosisRole 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error EpisodeOfCare If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error EpisodeOfCare 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 EpisodeOfCare 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 EpisodeOfCare If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice EpisodeOfCare 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()

Differential View

This structure is derived from EpisodeOfCare

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. EpisodeOfCare 0..* EpisodeOfCare An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
... status S 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
... statusHistory S 0..* BackboneElement Past list of status codes (the current status may be included to cover the start date of the status)
.... status S 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
.... period S 1..1 Period Duration the EpisodeOfCare was in the specified status
... type S 1..1 CodeableConcept Type/class - e.g. specialist referral, disease management
Binding: Episode of Care Type ValueSet (required)
.... coding S 1..* Coding Code defined by a terminology system
..... system S 1..1 uri Identity of the terminology system
..... code S 1..1 code Symbol in syntax defined by the system
..... display S 1..1 string Representation defined by the system
.... text S 0..1 string Plain text representation of the concept
.... condition S 1..1 Reference(Condition) Conditions/problems/diagnoses this episode of care is for
.... role S 0..1 CodeableConcept Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …)
Binding: DiagnosisRole (required)
..... coding S 1..* Coding Code defined by a terminology system
...... system S 1..1 uri Identity of the terminology system
...... code S 1..1 code Symbol in syntax defined by the system
...... display S 1..1 string Representation defined by the system
..... text S 0..1 string Plain text representation of the concept
... patient S 1..1 Reference(eClaims Patient Profile) The patient who is the focus of this episode of care
... managingOrganization S 1..1 Reference(eClaims Organization Profile) Organization that assumes care
... period S 1..1 Period Interval during responsibility is assumed
.... start S 1..1 dateTime Starting time with inclusive boundary
... referralRequest S 0..* Reference(ServiceRequest) Originating Referral Request(s)
... careManager S 0..1 Reference(Practitioner | PractitionerRole) Care manager/care coordinator for the patient
... team S 0..* Reference(CareTeam) Other practitioners facilitating this episode of care

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
EpisodeOfCare.status Base required EpisodeOfCareStatus 📦4.0.1 FHIR Std.
EpisodeOfCare.statusHistory.​status Base required EpisodeOfCareStatus 📦4.0.1 FHIR Std.
EpisodeOfCare.type Base required Episode of Care Type ValueSet 📦0.1.0 This IG
EpisodeOfCare.diagnosis.​role Base required DiagnosisRole 📦4.0.1 FHIR Std.

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. EpisodeOfCare 0..* EpisodeOfCare An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier Business Identifier(s) relevant for this EpisodeOfCare
... status ?!SΣ 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
... statusHistory S 0..* BackboneElement Past list of status codes (the current status may be included to cover the start date of the status)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... status S 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required)
.... period S 1..1 Period Duration the EpisodeOfCare was in the specified status
... type SΣ 1..1 CodeableConcept Type/class - e.g. specialist referral, disease management
Binding: Episode of Care Type ValueSet (required)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding SΣ 1..* Coding Code defined by a terminology system
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system SΣ 1..1 uri Identity of the terminology system
..... version Σ 0..1 string Version of the system - if relevant
..... code SΣ 1..1 code Symbol in syntax defined by the system
..... display SΣ 1..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text SΣ 0..1 string Plain text representation of the concept
... diagnosis SΣ 0..* BackboneElement The list of diagnosis relevant to this episode of care
.... 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 SΣ 1..1 Reference(Condition) Conditions/problems/diagnoses this episode of care is for
.... role SΣ 0..1 CodeableConcept Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …)
Binding: DiagnosisRole (required)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ 1..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display SΣ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text SΣ 0..1 string Plain text representation of the concept
.... rank Σ 0..1 positiveInt Ranking of the diagnosis (for each role type)
... patient SΣ 1..1 Reference(eClaims Patient Profile) The patient who is the focus of this episode of care
... managingOrganization SΣ 1..1 Reference(eClaims Organization Profile) Organization that assumes care
... period SΣ 1..1 Period Interval during responsibility is assumed
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... start SΣC 1..1 dateTime Starting time with inclusive boundary
.... end ΣC 0..1 dateTime End time with inclusive boundary, if not ongoing
... referralRequest S 0..* Reference(ServiceRequest) Originating Referral Request(s)
... careManager S 0..1 Reference(Practitioner | PractitionerRole) Care manager/care coordinator for the patient
... team S 0..* Reference(CareTeam) Other practitioners facilitating this episode of care
... account 0..* Reference(Account) The set of accounts that may be used for billing for this EpisodeOfCare

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
EpisodeOfCare.language Base preferred Common Languages 📍4.0.1 FHIR Std.
EpisodeOfCare.status Base required EpisodeOfCareStatus 📦4.0.1 FHIR Std.
EpisodeOfCare.statusHistory.​status Base required EpisodeOfCareStatus 📦4.0.1 FHIR Std.
EpisodeOfCare.type Base required Episode of Care Type ValueSet 📦0.1.0 This IG
EpisodeOfCare.diagnosis.​role Base required DiagnosisRole 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error EpisodeOfCare If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error EpisodeOfCare 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 EpisodeOfCare 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 EpisodeOfCare If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice EpisodeOfCare 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()

This structure is derived from EpisodeOfCare

Summary

Mandatory: 8 elements(4 nested mandatory elements)
Must-Support: 25 elements

Structures

This structure refers to these other structures:

 

Other representations of profile: CSV, Excel, Schematron