Millennium

Encounter

Overview

The Encounter resource provides admissions or visits during which health care services were provided to a patient. An encounter has a class to distinguish between different health care settings such as inpatient, outpatient, emergency, and so on. A patient may have one medical record number with multiple encounter numbers per facility or organization. There is substantial variance between organizations in the definition of an encounter and what events are aggregated together to constitute an encounter.

The following fields are returned if valued:

Terminology Bindings

Encounter.identifier.type
  • Description
    • The type used to determine which identifier to use for a specific purpose.

  • Details: Identifier Type Codes
    System: http://hl7.org/fhir/identifier-type

  • Details: v2 Identifier Type
    System: http://hl7.org/fhir/v2/0203

Encounter.type
  • Description
    • The type of encounter.
  • Note
    • Currently not bound to any terminology.
Encounter.priority
  • Description
    • Indicates the urgency of the encounter.

  • Details: Encounter Priority
    System: http://hl7.org/fhir/encounter-priority

Encounter.participant.type
Encounter.reason
  • Description
    • The type of encounter.
  • Note
    • Currently not bound to any terminology. The value would always be returned as a free-text value.
Encounter.hospitalization.admitSource
  • Description
    • From where patient was admitted.

  • Details: AdmitSource
    System: http://hl7.org/fhir/admit-source

Encounter.hospitalization.dietPreference
  • Description
    • Medical, cultural or ethical food preferences to help with catering requirements.

  • Details: Diet
    System: http://hl7.org/fhir/diet

Encounter.hospitalization.specialCourtesy
Encounter.hospitalization.specialArrangement
  • Description
    • Special arrangements.

  • Details: SpecialArrangements
    System: http://hl7.org/fhir/encounter-special-arrangements

Encounter.hospitalization.dischargeDisposition
  • Description
    • Discharge Disposition.

  • Details: DischargeDisposition
    System: http://hl7.org/fhir/discharge-disposition

Contained Location Bindings

Location.type
  • Description
    • Indicates the type of function performed at the location.

  • Details: v3 Code System RoleCode
    System: http://hl7.org/fhir/v3/RoleCode

Extensions

Custom Extensions

All URLs for custom extensions are defined as https://fhir-ehr.cerner.com/dstu2/StructureDefinition/{id}

Extension Value[x] Type Description
Encounter Guarantor (id: encounter-guarantor) None (contains nested extensions) The guarantors of the encounter.
Encounter Guarantor Party Reference A reference to a Patient, Person, or Organization.
Encounter Guarantor Period Period The period when this encounter guarantor is effective.

Search for Encounters that meet supplied query parameters:

GET /Encounter?:parameters

Implementation Notes

Authorization Types

Provider | Patient | System

Parameters

Name Required Type Description
_id Conditional token The logical resource ID associated with the Encounter. This parameter is required if patient is not used. Example: 7891
patient Conditional reference The Patient present at the Encounter. This parameter is required if _id is not used. Example: 12345

Headers

Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>

Example

Request

GET https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/Encounter?patient=12724066

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "73b0b7c8-e5e0-4e72-96f9-dcfb257fc40a",
  "type": "searchset",
  "total": 1,
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/Encounter?patient=12724066"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/Encounter/97953477",
      "resource": {
        "resourceType": "Encounter",
        "id": "97953477",
        "meta": {
          "versionId": "2",
          "lastUpdated": "2020-03-05T16:53:11.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div><p><b>Encounter</b></p><p><b>Patient Name</b>: SMART, NANCY</p><p><b>Location</b>: Model Hospital, MX Hospital, MAT, MB01, A</p><p><b>Type</b>: Inpatient</p><p><b>Class</b>: Inpatient</p><p><b>Status</b>: in Progress</p><p><b>Period Start Date</b>: Mar  4, 2020  5:01 P.M. UTC</p><p><b>Reason For Visit</b>: Maternity</p><p><b>Attending Physician</b>: Carter, Kristin Cerner</p></div>"
        },
        "extension": [
          {
            "url": "https://fhir-ehr.cerner.com/dstu2/StructureDefinition/encounter-guarantor",
            "extension": [
              {
                "url": "party",
                "valueReference": {
                  "reference": "Patient/12724066",
                  "display": "SMART, NANCY"
                }
              },
              {
                "url": "period",
                "valuePeriod": {
                  "start": "2020-03-04T17:19:56.000Z"
                }
              }
            ]
          }
        ],
        "identifier": [
          {
            "use": "usual",
            "type": {
              "text": "FIN NBR"
            },
            "value": "16000",
            "period": {
              "start": "2020-03-04T17:19:56.000Z"
            }
          }
        ],
        "status": "in-progress",
        "class": "inpatient",
        "type": [
          {
            "text": "Inpatient"
          }
        ],
        "priority": {
          "text": "Labor and Delivery"
        },
        "patient": {
          "reference": "Patient/12724066",
          "display": "SMART, NANCY"
        },
        "participant": [
          {
            "type": [
              {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/v3/ParticipationType",
                    "code": "ADM",
                    "display": "admitter",
                    "userSelected": false
                  }
                ],
                "text": "Admitting Physician"
              }
            ],
            "period": {
              "start": "2020-03-05T16:53:11.000Z"
            },
            "individual": {
              "reference": "Practitioner/4122622",
              "display": "Cerner Test, Physician - Hospitalist Cerner"
            }
          },
          {
            "type": [
              {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/v3/ParticipationType",
                    "code": "ATND",
                    "display": "attender",
                    "userSelected": false
                  }
                ],
                "text": "Attending Physician"
              }
            ],
            "period": {
              "start": "2020-03-05T16:53:11.000Z"
            },
            "individual": {
              "reference": "Practitioner/11817978",
              "display": "Carter, Kristin Cerner"
            }
          },
          {
            "type": [
              {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/v3/ParticipationType",
                    "code": "ATND",
                    "display": "attender",
                    "userSelected": false
                  }
                ],
                "text": "Attending Physician"
              }
            ],
            "period": {
              "start": "2020-03-04T17:19:56.000Z",
              "end": "2020-03-05T16:53:11.000Z"
            },
            "individual": {
              "reference": "Practitioner/4122630",
              "display": "Cerner Test, Physician - Women's Health Cerner"
            }
          },
          {
            "type": [
              {
                "text": "Other"
              }
            ],
            "period": {
              "start": "2020-04-21T16:19:37.000Z"
            },
            "individual": {
              "reference": "Practitioner/12742510",
              "display": "Kaehr, Andrew"
            }
          },
          {
            "type": [
              {
                "text": "Registered Nurse"
              }
            ],
            "period": {
              "start": "2020-03-05T16:53:00.000Z",
              "end": "2020-03-06T09:01:27.000Z"
            },
            "individual": {
              "reference": "Practitioner/683925",
              "display": "Cerner Test, Women's Health - Nurse Cerner"
            }
          },
          {
            "type": [
              {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/v3/ParticipationType",
                    "code": "REF",
                    "display": "referrer",
                    "userSelected": false
                  }
                ],
                "text": "Referring Physician"
              }
            ],
            "period": {
              "start": "2020-03-04T17:19:56.000Z"
            },
            "individual": {
              "reference": "Practitioner/4122630",
              "display": "Cerner Test, Physician - Women's Health Cerner"
            }
          }
        ],
        "period": {
          "start": "2020-03-04T17:01:59.000Z"
        },
        "reason": [
          {
            "text": "Maternity"
          }
        ],
        "hospitalization": {
          "admitSource": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/admit-source",
                "code": "other",
                "display": "Other",
                "userSelected": false
              }
            ],
            "text": "Information Not Available"
          }
        },
        "location": [
          {
            "location": {
              "reference": "Location/31100793",
              "display": "Model Hospital, MX Hospital, MAT, MB01, A"
            },
            "status": "active"
          }
        ],
        "serviceProvider": {
          "reference": "Organization/675844"
        }
      }
    }
  ]
}

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Errors

The common errors and OperationOutcomes may be returned.

Retrieve by ID

List an individual Encounter by the associated ID:

GET /Encounter/:id

Implementation Notes

Authorization Types

Provider | Patient | System

Headers

Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>

Example

Request

GET https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/Encounter/97953477

Response

Status: 200 OK
{
  "resourceType": "Encounter",
  "id": "97953477",
  "meta": {
    "versionId": "2",
    "lastUpdated": "2020-03-05T16:53:11.000Z"
  },
  "text": {
    "status": "generated",
    "div": "<div><p><b>Encounter</b></p><p><b>Patient Name</b>: SMART, NANCY</p><p><b>Location</b>: Model Hospital, MX Hospital, MAT, MB01, A</p><p><b>Type</b>: Inpatient</p><p><b>Class</b>: Inpatient</p><p><b>Status</b>: in Progress</p><p><b>Period Start Date</b>: Mar  4, 2020  5:01 P.M. UTC</p><p><b>Reason For Visit</b>: Maternity</p><p><b>Attending Physician</b>: Carter, Kristin Cerner</p></div>"
  },
  "extension": [
    {
      "url": "https://fhir-ehr.cerner.com/dstu2/StructureDefinition/encounter-guarantor",
      "extension": [
        {
          "url": "party",
          "valueReference": {
            "reference": "Patient/12724066",
            "display": "SMART, NANCY"
          }
        },
        {
          "url": "period",
          "valuePeriod": {
            "start": "2020-03-04T17:19:56.000Z"
          }
        }
      ]
    }
  ],
  "identifier": [
    {
      "use": "usual",
      "type": {
        "text": "FIN NBR"
      },
      "value": "16000",
      "period": {
        "start": "2020-03-04T17:19:56.000Z"
      }
    }
  ],
  "status": "in-progress",
  "class": "inpatient",
  "type": [
    {
      "text": "Inpatient"
    }
  ],
  "priority": {
    "text": "Labor and Delivery"
  },
  "patient": {
    "reference": "Patient/12724066",
    "display": "SMART, NANCY"
  },
  "participant": [
    {
      "type": [
        {
          "coding": [
            {
              "system": "http://hl7.org/fhir/v3/ParticipationType",
              "code": "ADM",
              "display": "admitter",
              "userSelected": false
            }
          ],
          "text": "Admitting Physician"
        }
      ],
      "period": {
        "start": "2020-03-05T16:53:11.000Z"
      },
      "individual": {
        "reference": "Practitioner/4122622",
        "display": "Cerner Test, Physician - Hospitalist Cerner"
      }
    },
    {
      "type": [
        {
          "coding": [
            {
              "system": "http://hl7.org/fhir/v3/ParticipationType",
              "code": "ATND",
              "display": "attender",
              "userSelected": false
            }
          ],
          "text": "Attending Physician"
        }
      ],
      "period": {
        "start": "2020-03-05T16:53:11.000Z"
      },
      "individual": {
        "reference": "Practitioner/11817978",
        "display": "Carter, Kristin Cerner"
      }
    },
    {
      "type": [
        {
          "coding": [
            {
              "system": "http://hl7.org/fhir/v3/ParticipationType",
              "code": "ATND",
              "display": "attender",
              "userSelected": false
            }
          ],
          "text": "Attending Physician"
        }
      ],
      "period": {
        "start": "2020-03-04T17:19:56.000Z",
        "end": "2020-03-05T16:53:11.000Z"
      },
      "individual": {
        "reference": "Practitioner/4122630",
        "display": "Cerner Test, Physician - Women&#39;s Health Cerner"
      }
    },
    {
      "type": [
        {
          "text": "Other"
        }
      ],
      "period": {
        "start": "2020-04-21T16:19:37.000Z"
      },
      "individual": {
        "reference": "Practitioner/12742510",
        "display": "Kaehr, Andrew"
      }
    },
    {
      "type": [
        {
          "text": "Registered Nurse"
        }
      ],
      "period": {
        "start": "2020-03-05T16:53:00.000Z",
        "end": "2020-03-06T09:01:27.000Z"
      },
      "individual": {
        "reference": "Practitioner/683925",
        "display": "Cerner Test, Women&#39;s Health - Nurse Cerner"
      }
    },
    {
      "type": [
        {
          "coding": [
            {
              "system": "http://hl7.org/fhir/v3/ParticipationType",
              "code": "REF",
              "display": "referrer",
              "userSelected": false
            }
          ],
          "text": "Referring Physician"
        }
      ],
      "period": {
        "start": "2020-03-04T17:19:56.000Z"
      },
      "individual": {
        "reference": "Practitioner/4122630",
        "display": "Cerner Test, Physician - Women&#39;s Health Cerner"
      }
    }
  ],
  "period": {
    "start": "2020-03-04T17:01:59.000Z"
  },
  "reason": [
    {
      "text": "Maternity"
    }
  ],
  "hospitalization": {
    "admitSource": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/admit-source",
          "code": "other",
          "display": "Other",
          "userSelected": false
        }
      ],
      "text": "Information Not Available"
    }
  },
  "location": [
    {
      "location": {
        "reference": "Location/31100793",
        "display": "Model Hospital, MX Hospital, MAT, MB01, A"
      },
      "status": "active"
    }
  ],
  "serviceProvider": {
    "reference": "Organization/675844"
  }
}

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Encounter Combines Example

Cerner Millennium supports the ability to logically merge an encounter record into another encounter record when both records are describing the same encounter. This is known as an encounter combine. If necessary, this merging can later be undone by performing an encounter uncombine. When the requested encounter record has been combined into another record, an inactive encounter entry is returned which has a reference to the current encounter entry in the partOf field. Entries for combined encounters will only be returned when retrieving the entries directly by ID. They will not be returned when searching with other parameters.

Request

GET https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/Encounter/97865451

Response

Status: 200 OK
{
  "resourceType": "Encounter",
  "id": "97865451",
  "text": {
    "status": "generated",
    "div": "<div><p><b>Encounter</b></p></div>"
  },
  "status": "unknown",
  "part_of": {
    "reference": "Encounter/97855447"
  }
}

Errors

The common errors and OperationOutcomes may be returned.