Guia de Implementação do Registro de Atendimento Clínico (RAC) da RNDS
0.1.0 - CI Build Brazil flag

Guia de Implementação do Registro de Atendimento Clínico (RAC) da RNDS - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: BRContatoAssistencial - Detailed Descriptions

Page standards status: Informative Maturity Level: 1

Definitions for the BRContatoAssistencial-1.0 resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Encounter
Definition

Atenção à saúde dispensada a um indivíduo em uma modalidade assistencial, de forma ininterrupta e em um mesmo estabelecimento de saúde.


An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.

ShortContato AssistencialAn interaction during which services are provided to the patient
Control0..*
Is Modifierfalse
Must Supporttrue
Summaryfalse
Alternate NamesVisit, Atendimento, Visita, Internação, Consulta, Atendimento Ambulatorial
Invariantsdom-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 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Encounter.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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Encounter.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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Encounter.identifier
Definition

Identifier(s) by which this encounter is known.

ShortIdentifier(s) by which this encounter is known
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..0*
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Encounter.status
Definition

Indica o estado que o contato assistencial se encontra quando é informado para a RNDS.


planned | arrived | triaged | in-progress | onleave | finished | cancelled +.

Shortfinished | entered-in-errorplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
Comments

Na RNDS os contatos assistenciais somente são informados após terem sido finalizados, portanto somente a opção finished pode ser utilizada, ou entered-in-error, quando o contato assistencial foi enviado com erro.


Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes).

Control1..1
BindingThe codes SHALL be taken from Estado do Contato Assistencialhttp://hl7.org/fhir/ValueSet/encounter-status|4.0.1
(required to http://www.saude.gov.br/fhir/r4/ValueSet/BREstadoContatoAssistencial-1.0)

Estado do Contato Assistencial


Current state of the encounter.

Typecode
Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Encounter.statusHistory
Definition

The status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them.

ShortList of past encounter statuses
Comments

The current status is always found in the current version of the resource, not the status history.

Control0..0*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
15. Encounter.class
Definition

Classifica os contatos assistenciais de acordo com as especificidades do modo, local e duração do atendimento. Referência: https://rts.saude.gov.br/#/modalidade-assistencial


Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.

ShortModalidade AssistencialClassification of patient encounter
Control1..1
BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from Modalidade Assistencialhttp://terminology.hl7.org/ValueSet/v3-ActEncounterCode
(required to http://www.saude.gov.br/fhir/r4/ValueSet/BRModalidadeAssistencial-1.0)

Modalidade Assistencial


Classification of the encounter.

TypeCoding
Is Modifierfalse
Must Supporttrue
Summarytrue
LabelModalidade Assistencial
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
17. Encounter.class.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

ShortIdentity of the terminology system
Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Control10..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
19. Encounter.class.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

ShortSymbol in syntax defined by the system
Control10..1
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need to refer to a particular code in the system.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
21. Encounter.class.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

ShortRepresentation defined by the system
Control0..01
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
23. Encounter.class.userSelected
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

ShortIf this coding was chosen directly by the user
Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Control0..01
Typeboolean
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
25. Encounter.classHistory
Definition

The class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transitions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kind of discharge from emergency to inpatient.

ShortList of past encounter classes
Control0..0*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Encounter.type
Definition

Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).

ShortSpecific type of encounter
Comments

Since there are many ways to further classify encounters, this element is 0..*.

Control0..0*
BindingFor example codes, see EncounterTypehttp://hl7.org/fhir/ValueSet/encounter-type
(example to http://hl7.org/fhir/ValueSet/encounter-type)

The type of encounter.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Encounter.serviceType
Definition

Broad categorization of the service that is to be provided (e.g. cardiology).

ShortSpecific type of service
Control0..01
BindingFor example codes, see ServiceTypehttp://hl7.org/fhir/ValueSet/service-type
(example to http://hl7.org/fhir/ValueSet/service-type)

Broad categorization of the service that is to be provided.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Encounter.priority
Definition

Identifica o contato assistencial de acordo com a prioridade de sua realização. Referência: https://rts.saude.gov.br/#/carater-atendimento


Indicates the urgency of the encounter.

ShortCaráter do AtendimentoIndicates the urgency of the encounter
Control10..1
BindingThe codes SHALL be taken from For example codes, see Caráter de atendimento do Contato Assistencialhttp://terminology.hl7.org/ValueSet/v3-ActPriority
(required to http://www.saude.gov.br/fhir/r4/ValueSet/BRCaraterAtendimento-1.0)

Identifica o contato assistencial de acordo com a prioridade de sua realização.


Indicates the urgency of the encounter.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
LabelCaráter do Atendimento
Alternate NamesCaráter de Atendimento, Caráter da Internação
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Encounter.priority.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Control10..1*
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Encounter.priority.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

ShortIdentity of the terminology system
Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Control10..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Encounter.priority.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

ShortSymbol in syntax defined by the system
Control10..1
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need to refer to a particular code in the system.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. Encounter.priority.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

ShortRepresentation defined by the system
Control0..01
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. Encounter.priority.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

ShortIf this coding was chosen directly by the user
Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Control0..01
Typeboolean
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. Encounter.priority.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

ShortPlain text representation of the concept
Comments

Very often the text is the same as a displayName of one of the codings.

Control0..01
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. Encounter.subject
Definition

The patient or group present at the encounter.

ShortThe patient or group present at the encounter
Comments

Na primeira versão não será suportado a identificação de grupos.


While the encounter is always about the patient, the patient might not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).

Control10..1
TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuo-1.0, Patient, Group)
Is Modifierfalse
Must Supporttrue
Summarytrue
Alternate Namespatient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. Encounter.subject.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Encounter.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 52. Encounter.subject.extension:unidentifiedPatient
    Slice NameunidentifiedPatient
    Definition

    Informações demográficas básicas e justificativa dos indivíduos que não podem ser identificados por razões clínicas ou sociais, conforme legislação brasileira, com finalidade estatística.

    ShortDados do Indivíduo Não Identificado
    Control0..*
    TypeExtension(Informações Complementares de Indivíduos Não Identificados) (Complex Extension)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    54. Encounter.subject.extension:unidentifiedPatient.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    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.

    Control30..3*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Encounter.subject.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 56. Encounter.subject.extension:unidentifiedPatient.extension:gender
      Slice Namegender
      Definition

      An Extension

      ShortExtensionAdditional content defined by implementations
      Control10..1*
      TypeExtension
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      58. Encounter.subject.extension:unidentifiedPatient.extension:gender.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuegender
      60. Encounter.subject.extension:unidentifiedPatient.extension:gender.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control10..1
      Typecode, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      62. Encounter.subject.extension:unidentifiedPatient.extension:birthYear
      Slice NamebirthYear
      Definition

      An Extension

      ShortExtensionAdditional content defined by implementations
      Control10..1*
      TypeExtension
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      64. Encounter.subject.extension:unidentifiedPatient.extension:birthYear.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed ValuebirthYear
      66. Encounter.subject.extension:unidentifiedPatient.extension:birthYear.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control10..1
      Typedate, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      68. Encounter.subject.extension:unidentifiedPatient.extension:reason
      Slice Namereason
      Definition

      An Extension

      ShortExtensionAdditional content defined by implementations
      Control10..1*
      TypeExtension
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      70. Encounter.subject.extension:unidentifiedPatient.extension:reason.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuereason
      72. Encounter.subject.extension:unidentifiedPatient.extension:reason.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control10..1
      TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      74. Encounter.subject.extension:unidentifiedPatient.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttp://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuoNaoIdentificado-1.0
      76. Encounter.subject.extension:unidentifiedPatient.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control0..01
      TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      78. Encounter.subject.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control0..01
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      80. Encounter.subject.type
      Definition

      The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

      The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

      ShortType the reference refers to (e.g. "Patient")
      Comments

      This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

      Control0..01
      BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
      (extensible to http://hl7.org/fhir/ValueSet/resource-types)

      Aa resource (or, for logical models, the URI of the logical model).

      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Fixed ValuePatient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      82. Encounter.subject.display
      Definition

      Nome do indivíduo ou descrição do sujeito do Contato Assistencial quando não for um indivíduo.


      Plain text narrative that identifies the resource in addition to the resource reference.

      ShortNome ou descrição do sujeitoText alternative for the resource
      Comments

      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

      Control0..01
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      84. Encounter.episodeOfCare
      Definition

      Where a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years).

      ShortEpisode(s) of care that this encounter should be recorded against
      Control0..0*
      TypeReference(EpisodeOfCare)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      86. Encounter.basedOn
      Definition

      The request this encounter satisfies (e.g. incoming referral or procedure request).

      ShortThe ServiceRequest that initiated this encounter
      Control0..0*
      TypeReference(ServiceRequest)
      Is Modifierfalse
      Summaryfalse
      Alternate NamesincomingReferral
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      88. Encounter.participant
      Definition

      Identifica o(s) profissional(is) ou indivíduo(s) que teve(tiveram) algum tipo de participação no Contato Assistencial.


      The list of people responsible for providing the service.

      ShortParticipante(s) do Contato AssistencialList of participants involved in the encounter
      Control10..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Alternate NamesProfissionais do Atendimento, Profissional Responsável pela Alta
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      90. Encounter.participant.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional content defined by implementations
      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.

      Control10..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Encounter.participant.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 92. Encounter.participant.extension:function
        Slice Namefunction
        Definition

        Ocupação do profissional ou indivíduo que participou do contato assistencial.

        ShortOcupação
        Control1..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Ocupação) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        94. Encounter.participant.extension:team
        Slice Nameteam
        Definition

        Identifica a equipe de saúde responsável pelo Contato Assistencial utilizando o Identificador Nacional de Equipes.

        ShortEquipe
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Identificador Nacional de Equipe) (Extension Type: integer)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        96. Encounter.participant.extension:isResponsable
        Slice NameisResponsable
        Definition

        Representa se o profissional foi responsável pelo atendimento registrado.

        ShortResponsável pelo Atendimento
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Responsável pelo Atendimento) (Extension Type: Choice of: boolean, Coding)
        Is Modifierfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        98. Encounter.participant.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        100. Encounter.participant.type
        Definition

        Responsabilidade que o profissional ou indivíduo teve durante o Contato Assistencial.


        Role of participant in encounter.

        ShortTipo de ParticipaçãoRole of participant in encounter
        Comments

        The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

        Control10..1*
        BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from Reponsabilidade no Contato Assistencialhttp://hl7.org/fhir/ValueSet/encounter-participant-type
        (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRResponsabilidadeParticipante-1.0)

        Responsabilidade no Contato Assistencial


        Role of participant in encounter.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        102. Encounter.participant.type.text
        Definition

        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        ShortPlain text representation of the concept
        Comments

        Very often the text is the same as a displayName of one of the codings.

        Control0..01
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        104. Encounter.participant.period
        Definition

        The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.

        ShortPeriod of time during the encounter that the participant participated
        Control0..01
        TypePeriod
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        106. Encounter.participant.individual
        Definition

        Identifica o profissional ou indivíduo teve alguma participação no Contato Assistencial.


        Persons involved in the encounter other than the patient.

        ShortParticipantePersons involved in the encounter other than the patient
        Control10..1
        TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRLotacaoProfissional-1.0, http://www.saude.gov.br/fhir/r4/StructureDefinition/BRProfissional-1.0, Practitioner, PractitionerRole, RelatedPerson)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        108. Encounter.participant.individual.reference
        Definition

        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

        ShortLiteral reference, Relative, internal or absolute URL
        Comments

        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

        Control0..01
        This element is affected by the following invariants: ref-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        110. Encounter.participant.individual.type
        Definition

        The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

        The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

        ShortType the reference refers to (e.g. "Patient")
        Comments

        This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

        Control0..01
        BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
        (extensible to http://hl7.org/fhir/ValueSet/resource-types)

        Aa resource (or, for logical models, the URI of the logical model).

        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        112. Encounter.participant.individual.identifier
        Definition

        An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

        ShortLogical reference, when literal reference is not known
        Comments

        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

        Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control10..1
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        114. Encounter.participant.individual.identifier.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control0..01
        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        116. Encounter.participant.individual.identifier.type
        Definition

        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

        ShortDescription of identifier
        Comments

        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

        Control0..01
        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

        A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        Allows users to make use of identifiers when the identifier system is not known.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        118. Encounter.participant.individual.identifier.system
        Definition

        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

        ShortThe namespace for the identifier value
        Comments

        Identifier.system is always case sensitive.

        Control10..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        120. Encounter.participant.individual.identifier.value
        Definition

        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortThe value that is unique
        Comments

        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Example<br/><b>General</b>:123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        122. Encounter.participant.individual.identifier.period
        Definition

        Time period during which identifier is/was valid for use.

        ShortTime period when id is/was valid for use
        Control0..01
        TypePeriod
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        124. Encounter.participant.individual.identifier.assigner
        Definition

        Organization that issued/manages the identifier.

        ShortOrganization that issued id (may be just text)
        Comments

        The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

        Control0..01
        TypeReference(Organization)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        126. Encounter.participant.individual.display
        Definition

        Plain text narrative that identifies the resource in addition to the resource reference.

        ShortText alternative for the resource
        Comments

        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

        Control0..01
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        128. Encounter.appointment
        Definition

        The appointment that scheduled this encounter.

        ShortThe appointment that scheduled this encounter
        Control0..0*
        TypeReference(Appointment)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        130. Encounter.period
        Definition

        Data ou data/hora de adminissão e desfecho do Contato Assistencial.


        The start and end time of the encounter.

        ShortInício e Término do Contato AssistencialThe start and end time of the encounter
        Comments

        If not (yet) known, the end of the Period may be omitted.

        Control10..1
        TypePeriod
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        132. Encounter.period.start
        Definition

        Competência (mês/ano), data ou data e hora do início do Contato Assistencial.


        The start of the period. The boundary is inclusive.

        ShortMomento da AdmissãoStarting time with inclusive boundary
        Comments

        If the low element is missing, the meaning is that the low boundary is not known.

        Control10..1
        This element is affected by the following invariants: per-1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Alternate NamesData da Admissão, Data e Hora do Atendimento, Data e Hora da Admissão
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        134. Encounter.period.end
        Definition

        Competência (mês/ano), data ou data e hora do término do Contato Assistencial.


        The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

        ShortMomento do DesfechoEnd time with inclusive boundary, if not ongoing
        Comments

        The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

        Control10..1
        This element is affected by the following invariants: per-1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Alternate NamesData do Desfecho, Data e Hora da Saída da Internação
        Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        136. Encounter.length
        Definition

        Quantity of time the encounter lasted. This excludes the time during leaves of absence.

        ShortQuantity of time the encounter lasted (less time absent)
        Comments

        May differ from the time the Encounter.period lasted because of leave of absence.

        Control0..01
        TypeDuration
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        138. Encounter.reasonCode
        Definition

        Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.

        ShortCoded reason the encounter takes place
        Comments

        For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

        Control0..0*
        BindingThe codes SHOULD be taken from EncounterReasonCodeshttp://hl7.org/fhir/ValueSet/encounter-reason
        (preferred to http://hl7.org/fhir/ValueSet/encounter-reason)

        Reason why the encounter takes place.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Alternate NamesIndication, Admission diagnosis
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        140. Encounter.reasonReference
        Definition

        Motivação para o Contato Assistencial acontecer.


        Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.

        ShortMotivo do AtendimentoReason the encounter takes place (reference)
        Comments

        For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

        Control0..1*
        TypeReference(Observação Descritiva, Condition, Procedure, Observation, ImmunizationRecommendation)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Alternate NamesIndication, Admission diagnosis, Motivo do Contato Assistencial, Diangóstico Principal, Motivo da Admissão
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        142. Encounter.reasonReference.reference
        Definition

        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

        ShortLiteral reference, Relative, internal or absolute URL
        Comments

        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

        Control10..1
        This element is affected by the following invariants: ref-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        144. Encounter.reasonReference.type
        Definition

        The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

        The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

        ShortType the reference refers to (e.g. "Patient")
        Comments

        This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

        Control0..01
        BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
        (extensible to http://hl7.org/fhir/ValueSet/resource-types)

        Aa resource (or, for logical models, the URI of the logical model).

        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        146. Encounter.reasonReference.identifier
        Definition

        An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

        ShortLogical reference, when literal reference is not known
        Comments

        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

        Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..01
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        148. Encounter.reasonReference.display
        Definition

        Plain text narrative that identifies the resource in addition to the resource reference.

        ShortText alternative for the resource
        Comments

        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

        Control0..01
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        150. Encounter.diagnosis
        Definition

        Referência a diagnóstico(s) secundário(s) avaliado(s), outro(s) problema(s) avaliado(s) e/ou procedimento(s) realizado(s) durante o contato assistencial.


        The list of diagnosis relevant to this encounter.

        ShortDiagnósticos Secundários, Outros Problemas e ProcedimentosThe list of diagnosis relevant to this encounter
        Control10..*
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Alternate NamesProblemas/Diagnósticos Avaliados, Procedimento Executado, Procedimento Realizado
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Encounter.diagnosis. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • profile @ condition.resolve()
        • 152. Encounter.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          154. Encounter.diagnosis.condition
          Definition

          Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.

          ShortThe diagnosis or procedure relevant to the encounter
          Comments

          For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

          Control1..1
          TypeReference(Condition, Procedure)
          Is Modifierfalse
          Summarytrue
          Alternate NamesAdmission diagnosis, discharge diagnosis, indication
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          156. Encounter.diagnosis:problemAndDiagnosis
          Slice NameproblemAndDiagnosis
          Definition

          Informações sobre a condição de saúde, lesão, deficiência ou qualquer outra questão que afete o bem-estar físico, mental ou social de um indivíduo identificadas em um contato assistencial. (adaptado do conceito de Problema/Diagnóstico do Clinical Knowledge Manager/OpenEHR) Devem ser listados os problemas/diangnósticos avaliados durante um contato. Diagnóstico secundário é(são) a(s) condição(ões) que coexiste(m) no momento da admissão, que se desenvolve(m) durante o contato assistencial ou que afeta(m) a atenção recebida e/ou a duração do contato assistencial. (adaptado do conceito disposto no Art. 3º da Portaria SAS/MS nº 1.324, de 27 de novembro de 2014)


          The list of diagnosis relevant to this encounter.

          ShortDiagnósticos/Problemas AvaliadosThe list of diagnosis relevant to this encounter
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Alternate NamesDiagnóstico Secundário
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          158. Encounter.diagnosis:problemAndDiagnosis.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          160. Encounter.diagnosis:problemAndDiagnosis.condition
          Definition

          Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.

          ShortThe diagnosis or procedure relevant to the encounter
          Comments

          For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

          Control1..1
          TypeReference(Problema / Diagnóstico, Condition, Procedure)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Alternate NamesAdmission diagnosis, discharge diagnosis, indication
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          162. Encounter.diagnosis:problemAndDiagnosis.condition.reference
          Definition

          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

          ShortLiteral reference, Relative, internal or absolute URL
          Comments

          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

          Control10..1
          This element is affected by the following invariants: ref-1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          164. Encounter.diagnosis:problemAndDiagnosis.condition.type
          Definition

          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

          ShortType the reference refers to (e.g. "Patient")
          Comments

          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

          Control0..01
          BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
          (extensible to http://hl7.org/fhir/ValueSet/resource-types)

          Aa resource (or, for logical models, the URI of the logical model).

          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          166. Encounter.diagnosis:problemAndDiagnosis.condition.identifier
          Definition

          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

          ShortLogical reference, when literal reference is not known
          Comments

          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..01
          TypeIdentifier
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          168. Encounter.diagnosis:problemAndDiagnosis.condition.display
          Definition

          Plain text narrative that identifies the resource in addition to the resource reference.

          ShortText alternative for the resource
          Comments

          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

          Control0..01
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          170. Encounter.diagnosis:problemAndDiagnosis.use
          Definition

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

          ShortRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
          Control0..1
          BindingThe codes SHALL be taken from The codes SHOULD be taken from Classificação do papel de um problema e diagnósticohttp://hl7.org/fhir/ValueSet/diagnosis-role
          (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRPapelProblemaDiagnostico)

          Papel de um problema/diagnóstico.


          The type of diagnosis this condition represents.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          172. Encounter.diagnosis:problemAndDiagnosis.use.coding
          Definition

          A reference to a code defined by a terminology system.

          ShortCode defined by a terminology system
          Comments

          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

          Control10..1*
          TypeCoding
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows for alternative encodings within a code system, and translations to other code systems.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          174. Encounter.diagnosis:problemAndDiagnosis.use.coding.system
          Definition

          The identification of the code system that defines the meaning of the symbol in the code.

          ShortIdentity of the terminology system
          Comments

          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

          Control10..1
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need to be unambiguous about the source of the definition of the symbol.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          176. Encounter.diagnosis:problemAndDiagnosis.use.coding.code
          Definition

          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          ShortSymbol in syntax defined by the system
          Control10..1
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need to refer to a particular code in the system.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          178. Encounter.diagnosis:problemAndDiagnosis.use.coding.userSelected
          Definition

          Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

          ShortIf this coding was chosen directly by the user
          Comments

          Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

          Control0..01
          Typeboolean
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          180. Encounter.diagnosis:problemAndDiagnosis.use.text
          Definition

          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

          ShortPlain text representation of the concept
          Comments

          Very often the text is the same as a displayName of one of the codings.

          Control0..01
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          182. Encounter.diagnosis:problemAndDiagnosis.rank
          Definition

          Ranking of the diagnosis (for each role type).

          ShortDiagnostico principal ou secundárioRanking of the diagnosis (for each role type)
          Control0..1
          TypepositiveInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          184. Encounter.diagnosis:procedure
          Slice Nameprocedure
          Definition

          Ação(ões) e/ou serviço(s) de saúde realizado(s) no/para o indivíduo.


          The list of diagnosis relevant to this encounter.

          ShortProcedimento(s) Realizado(s)The list of diagnosis relevant to this encounter
          Control10..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Alternate NamesProcedimento Executado
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          186. Encounter.diagnosis:procedure.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          188. Encounter.diagnosis:procedure.condition
          Definition

          Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.

          ShortThe diagnosis or procedure relevant to the encounter
          Comments

          For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

          Control1..1
          TypeReference(Procedimento Realizado, Condition, Procedure)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Alternate NamesAdmission diagnosis, discharge diagnosis, indication
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          190. Encounter.diagnosis:procedure.condition.extension
          Definition

          An Extension


          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortExtensionAdditional content defined by implementations
          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.

          Control10..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Encounter.diagnosis.condition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 192. Encounter.diagnosis:procedure.condition.extension:financier
            Slice Namefinancier
            Definition

            Agente, instituição ou entidade responsável por custear as ações e serviços de saúde.

            ShortFinanciamento
            Control1..1
            TypeExtension(Financiamento) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            194. Encounter.diagnosis:procedure.condition.reference
            Definition

            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

            ShortLiteral reference, Relative, internal or absolute URL
            Comments

            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

            Control10..1
            This element is affected by the following invariants: ref-1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            196. Encounter.diagnosis:procedure.condition.identifier
            Definition

            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

            ShortLogical reference, when literal reference is not known
            Comments

            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..01
            TypeIdentifier
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            198. Encounter.diagnosis:procedure.condition.display
            Definition

            Plain text narrative that identifies the resource in addition to the resource reference.

            ShortText alternative for the resource
            Comments

            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

            Control0..01
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            200. Encounter.diagnosis:procedure.use
            Definition

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

            ShortRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
            Control0..01
            BindingThe codes SHOULD be taken from DiagnosisRolehttp://hl7.org/fhir/ValueSet/diagnosis-role
            (preferred to http://hl7.org/fhir/ValueSet/diagnosis-role)

            The type of diagnosis this condition represents.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            202. Encounter.diagnosis:procedure.rank
            Definition

            Ranking of the diagnosis (for each role type).

            ShortRanking of the diagnosis (for each role type)
            Control0..01
            TypepositiveInt
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            204. Encounter.account
            Definition

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

            ShortThe set of accounts that may be used for billing for this Encounter
            Comments

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

            Control0..0*
            TypeReference(Account)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            206. Encounter.hospitalization
            Definition

            Details about the admission to a healthcare service.

            ShortDetails about the admission to a healthcare service
            Comments

            An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.

            The duration recorded in the period of this encounter covers the entire scope of this hospitalization record.

            Control10..1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            208. Encounter.hospitalization.extension
            Definition

            An Extension


            May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortExtensionAdditional content defined by implementations
            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.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Encounter.hospitalization.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 210. Encounter.hospitalization.extension:otherInformations
              Slice NameotherInformations
              Definition

              Representa quaisquer outras informações descritivas relacionadas aos dados de desfecho do atendimento registrado.

              ShortOutras Informações
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Outras Informações) (Extension Type: Annotation)
              Is Modifierfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              212. Encounter.hospitalization.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              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.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              214. Encounter.hospitalization.preAdmissionIdentifier
              Definition

              Pre-admission identifier.

              ShortPre-admission identifier
              Control0..01
              TypeIdentifier
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              216. Encounter.hospitalization.origin
              Definition

              The location/organization from which the patient came before admission.

              ShortThe location/organization from which the patient came before admission
              Control0..01
              TypeReference(Location, Organization)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              218. Encounter.hospitalization.admitSource
              Definition

              Identifica o serviço que encaminhou o indivíduo ou a sua iniciativa/de seu responsável na busca pelo acesso ao serviço de saúde.


              From where patient was admitted (physician referral, transfer).

              ShortProcedênciaFrom where patient was admitted (physician referral, transfer)
              Control10..1
              BindingThe codes SHALL be taken from The codes SHOULD be taken from Procedência do Contato Assistencialhttp://hl7.org/fhir/ValueSet/encounter-admit-source
              (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRProcedencia-1.0)

              Procedência


              From where the patient was admitted.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              220. Encounter.hospitalization.admitSource.coding
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control10..1*
              TypeCoding
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              222. Encounter.hospitalization.admitSource.coding.system
              Definition

              The identification of the code system that defines the meaning of the symbol in the code.

              ShortIdentity of the terminology system
              Comments

              The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

              Control10..1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Need to be unambiguous about the source of the definition of the symbol.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              224. Encounter.hospitalization.admitSource.coding.code
              Definition

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

              ShortSymbol in syntax defined by the system
              Control10..1
              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Need to refer to a particular code in the system.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              226. Encounter.hospitalization.admitSource.coding.display
              Definition

              A representation of the meaning of the code in the system, following the rules of the system.

              ShortRepresentation defined by the system
              Control0..01
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              228. Encounter.hospitalization.admitSource.coding.userSelected
              Definition

              Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

              ShortIf this coding was chosen directly by the user
              Comments

              Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

              Control0..01
              Typeboolean
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              230. Encounter.hospitalization.admitSource.text
              Definition

              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

              ShortPlain text representation of the concept
              Comments

              Very often the text is the same as a displayName of one of the codings.

              Control0..01
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              232. Encounter.hospitalization.reAdmission
              Definition

              Whether this hospitalization is a readmission and why if known.

              ShortThe type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
              Control0..01
              BindingFor example codes, see hl7VS-re-admissionIndicatorhttp://terminology.hl7.org/ValueSet/v2-0092
              (example to http://terminology.hl7.org/ValueSet/v2-0092)

              The reason for re-admission of this hospitalization encounter.

              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              234. Encounter.hospitalization.dietPreference
              Definition

              Diet preferences reported by the patient.

              ShortDiet preferences reported by the patient
              Comments

              For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).

              Control0..0*
              BindingFor example codes, see Diethttp://hl7.org/fhir/ValueSet/encounter-diet
              (example to http://hl7.org/fhir/ValueSet/encounter-diet)

              Medical, cultural or ethical food preferences to help with catering requirements.

              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Requirements

              Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              236. Encounter.hospitalization.specialCourtesy
              Definition

              Special courtesies (VIP, board member).

              ShortSpecial courtesies (VIP, board member)
              Control0..0*
              BindingThe codes SHOULD be taken from SpecialCourtesyhttp://hl7.org/fhir/ValueSet/encounter-special-courtesy
              (preferred to http://hl7.org/fhir/ValueSet/encounter-special-courtesy)

              Special courtesies.

              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              238. Encounter.hospitalization.specialArrangement
              Definition

              Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.

              ShortWheelchair, translator, stretcher, etc.
              Control0..0*
              BindingThe codes SHOULD be taken from SpecialArrangementshttp://hl7.org/fhir/ValueSet/encounter-special-arrangements
              (preferred to http://hl7.org/fhir/ValueSet/encounter-special-arrangements)

              Special arrangements.

              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              240. Encounter.hospitalization.destination
              Definition

              Location/organization to which the patient is discharged.

              ShortLocation/organization to which the patient is discharged
              Control0..01
              TypeReference(Location, Organization)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              242. Encounter.hospitalization.dischargeDisposition
              Definition

              Caracteriza o motivo de conclusão total ou parcial do Contato Assistencial.


              Category or kind of location after discharge.

              ShortMotivo de DesfechoCategory or kind of location after discharge
              Control10..1
              BindingThe codes SHALL be taken from For example codes, see Motivo do desfecho do Contato assistencialhttp://hl7.org/fhir/ValueSet/encounter-discharge-disposition
              (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRMotivoDesfecho-1.0)

              Motivo do Desfecho


              Discharge Disposition.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Alternate NamesDesfecho da Internação
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              244. Encounter.hospitalization.dischargeDisposition.coding
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control10..1*
              TypeCoding
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              246. Encounter.hospitalization.dischargeDisposition.coding.system
              Definition

              The identification of the code system that defines the meaning of the symbol in the code.

              ShortIdentity of the terminology system
              Comments

              The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

              Control10..1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Need to be unambiguous about the source of the definition of the symbol.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              248. Encounter.hospitalization.dischargeDisposition.coding.code
              Definition

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

              ShortSymbol in syntax defined by the system
              Control10..1
              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Need to refer to a particular code in the system.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              250. Encounter.hospitalization.dischargeDisposition.coding.display
              Definition

              A representation of the meaning of the code in the system, following the rules of the system.

              ShortRepresentation defined by the system
              Control0..01
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              252. Encounter.hospitalization.dischargeDisposition.coding.userSelected
              Definition

              Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

              ShortIf this coding was chosen directly by the user
              Comments

              Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

              Control0..01
              Typeboolean
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              254. Encounter.hospitalization.dischargeDisposition.text
              Definition

              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

              ShortPlain text representation of the concept
              Comments

              Very often the text is the same as a displayName of one of the codings.

              Control0..01
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              256. Encounter.location
              Definition

              Local onde o atendimento aconteceu.


              List of locations where the patient has been during this encounter.

              ShortLocal de AtendimentoList of locations where the patient has been
              Comments

              Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".

              Control0..1*
              TypeBackboneElement
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              258. Encounter.location.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              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.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              260. Encounter.location.location
              Definition

              The location where the encounter takes place.

              ShortLocation the encounter takes place
              Control1..1
              TypeReference(Local de Atendimento, Location)
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              262. Encounter.location.location.reference
              Definition

              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

              ShortLiteral reference, Relative, internal or absolute URL
              Comments

              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

              Control10..1
              This element is affected by the following invariants: ref-1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              264. Encounter.location.location.type
              Definition

              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

              ShortType the reference refers to (e.g. "Patient")
              Comments

              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

              Control0..01
              BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
              (extensible to http://hl7.org/fhir/ValueSet/resource-types)

              Aa resource (or, for logical models, the URI of the logical model).

              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              266. Encounter.location.location.identifier
              Definition

              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

              ShortLogical reference, when literal reference is not known
              Comments

              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..01
              TypeIdentifier
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              268. Encounter.location.location.display
              Definition

              Plain text narrative that identifies the resource in addition to the resource reference.

              ShortText alternative for the resource
              Comments

              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

              Control0..01
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              270. Encounter.location.status
              Definition

              The status of the participants' presence at the specified location during the period specified. If the participant is no longer at the location, then the period will have an end date/time.

              Shortplanned | active | reserved | completed
              Comments

              When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed.

              Control0..01
              BindingThe codes SHALL be taken from EncounterLocationStatushttp://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1
              (required to http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1)

              The status of the location.

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              272. Encounter.location.physicalType
              Definition

              This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query.

              ShortThe physical type of the location (usually the level in the location hierachy - bed room ward etc.)
              Comments

              This information is de-normalized from the Location resource to support the easier understanding of the encounter resource and processing in messaging or query.

              There may be many levels in the hierachy, and this may only pic specific levels that are required for a specific usage scenario.

              Control0..01
              BindingFor example codes, see LocationTypehttp://hl7.org/fhir/ValueSet/location-physical-type
              (example to http://hl7.org/fhir/ValueSet/location-physical-type)

              Physical form of the location.

              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              274. Encounter.location.period
              Definition

              Time period during which the patient was present at the location.

              ShortTime period during which the patient was present at the location
              Control0..01
              TypePeriod
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              276. Encounter.serviceProvider
              Definition

              Identifica pelo número de inscrição no Cadastro Nacional de Estabelecimentos de Saúde o Estabelecimento de Saúde que realizou o Contato Assistencial.


              The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy.

              ShortEstabelecimento de Saúde do Contato AssistencialThe organization (facility) responsible for this encounter
              Control10..1
              TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BREstabelecimentoSaude-1.0, http://www.saude.gov.br/fhir/r4/StructureDefinition/BRPessoaJuridicaProfissionalLiberal-1.0, Organization)
              Is Modifierfalse
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              278. Encounter.serviceProvider.reference
              Definition

              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

              ShortLiteral reference, Relative, internal or absolute URL
              Comments

              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

              Control0..01
              This element is affected by the following invariants: ref-1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              280. Encounter.serviceProvider.type
              Definition

              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

              ShortType the reference refers to (e.g. "Patient")
              Comments

              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

              Control0..01
              BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
              (extensible to http://hl7.org/fhir/ValueSet/resource-types)

              Aa resource (or, for logical models, the URI of the logical model).

              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              282. Encounter.serviceProvider.identifier
              Definition

              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

              ShortLogical reference, when literal reference is not known
              Comments

              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control10..1
              TypeIdentifier
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              284. Encounter.serviceProvider.identifier.use
              Definition

              The purpose of this identifier.

              Shortusual | official | temp | secondary | old (If known)
              Comments

              Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

              Control0..01
              BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
              (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

              Identifies the purpose for this identifier, if known .

              Typecode
              Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              286. Encounter.serviceProvider.identifier.type
              Definition

              A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

              ShortDescription of identifier
              Comments

              This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

              Control0..01
              BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
              (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

              A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows users to make use of identifiers when the identifier system is not known.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              288. Encounter.serviceProvider.identifier.system
              Definition

              Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

              ShortThe namespace for the identifier value
              Comments

              Identifier.system is always case sensitive.

              Control10..1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

              Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              290. Encounter.serviceProvider.identifier.value
              Definition

              The portion of the identifier typically relevant to the user and which is unique within the context of the system.

              ShortThe value that is unique
              Comments

              If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

              Control10..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Example<br/><b>General</b>:123456
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              292. Encounter.serviceProvider.identifier.period
              Definition

              Time period during which identifier is/was valid for use.

              ShortTime period when id is/was valid for use
              Control0..01
              TypePeriod
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              294. Encounter.serviceProvider.identifier.assigner
              Definition

              Organization that issued/manages the identifier.

              ShortOrganization that issued id (may be just text)
              Comments

              The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

              Control0..01
              TypeReference(Organization)
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              296. Encounter.serviceProvider.display
              Definition

              Plain text narrative that identifies the resource in addition to the resource reference.

              ShortText alternative for the resource
              Comments

              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

              Control0..01
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              298. Encounter.partOf
              Definition

              Permite referenciar outro Contato Assistencial que tenha dado sequência a este, como por exemplo, um indivíduo realiza, em um mesmo Estabelecimento de Saúde, um Contato Assistencial que seja de Modalidade Assistencial Atenção à Urgência/Emergência, e necessite ser internado, dando continuidade em um Contato Assistencial de Atenção Hospitalar. Neste exemplo, este elemento seria utilizado no Contato Assistencial de Atenção Hospitalar, que faria referência ao Contato Assistencial de Atenção à Urgência/Emergência.


              Another Encounter of which this encounter is a part of (administratively or in time).

              ShortContato Assistencial anteriorAnother Encounter this encounter is part of
              Comments

              This is also used for associating a child's encounter back to the mother's encounter.

              Refer to the Notes section in the Patient resource for further details.

              Control0..1
              TypeReference(Contato Assistencial, Encounter)
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              300. Encounter.partOf.reference
              Definition

              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

              ShortLiteral reference, Relative, internal or absolute URL
              Comments

              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

              Control10..1
              This element is affected by the following invariants: ref-1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              302. Encounter.partOf.type
              Definition

              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

              ShortType the reference refers to (e.g. "Patient")
              Comments

              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

              Control0..01
              BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
              (extensible to http://hl7.org/fhir/ValueSet/resource-types)

              Aa resource (or, for logical models, the URI of the logical model).

              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              304. Encounter.partOf.identifier
              Definition

              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

              ShortLogical reference, when literal reference is not known
              Comments

              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..01
              TypeIdentifier
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              306. Encounter.partOf.display
              Definition

              Plain text narrative that identifies the resource in addition to the resource reference.

              ShortText alternative for the resource
              Comments

              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

              Control0..01
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

              Guidance on how to interpret the contents of this table can be found here

              0. Encounter
              Definition

              Atenção à saúde dispensada a um indivíduo em uma modalidade assistencial, de forma ininterrupta e em um mesmo estabelecimento de saúde.

              ShortContato Assistencial
              Must Supporttrue
              Alternate NamesAtendimento, Visita, Internação, Consulta, Atendimento Ambulatorial
              2. Encounter.identifier
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..0
              4. Encounter.status
              Definition

              Indica o estado que o contato assistencial se encontra quando é informado para a RNDS.

              Shortfinished | entered-in-error
              Comments

              Na RNDS os contatos assistenciais somente são informados após terem sido finalizados, portanto somente a opção finished pode ser utilizada, ou entered-in-error, quando o contato assistencial foi enviado com erro.

              BindingThe codes SHALL be taken from Estado do Contato Assistencial
              (required to http://www.saude.gov.br/fhir/r4/ValueSet/BREstadoContatoAssistencial-1.0)

              Estado do Contato Assistencial

              Must Supporttrue
              6. Encounter.statusHistory
              Control0..0
              8. Encounter.class
              Definition

              Classifica os contatos assistenciais de acordo com as especificidades do modo, local e duração do atendimento. Referência: https://rts.saude.gov.br/#/modalidade-assistencial

              ShortModalidade Assistencial
              BindingThe codes SHALL be taken from Modalidade Assistencial
              (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRModalidadeAssistencial-1.0)

              Modalidade Assistencial

              Must Supporttrue
              LabelModalidade Assistencial
              10. Encounter.class.system
              Control1..?
              12. Encounter.class.code
              Control1..?
              14. Encounter.class.display
              Control0..0
              16. Encounter.class.userSelected
              Control0..0
              18. Encounter.classHistory
              Control0..0
              20. Encounter.type
              Control0..0
              22. Encounter.serviceType
              Control0..0
              24. Encounter.priority
              Definition

              Identifica o contato assistencial de acordo com a prioridade de sua realização. Referência: https://rts.saude.gov.br/#/carater-atendimento

              ShortCaráter do Atendimento
              Control1..?
              BindingThe codes SHALL be taken from Caráter de atendimento do Contato Assistencial
              (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRCaraterAtendimento-1.0)

              Identifica o contato assistencial de acordo com a prioridade de sua realização.

              Must Supporttrue
              LabelCaráter do Atendimento
              Alternate NamesCaráter de Atendimento, Caráter da Internação
              26. Encounter.priority.coding
              Control1..1
              28. Encounter.priority.coding.system
              Control1..?
              30. Encounter.priority.coding.code
              Control1..?
              32. Encounter.priority.coding.display
              Control0..0
              34. Encounter.priority.coding.userSelected
              Control0..0
              36. Encounter.priority.text
              Control0..0
              38. Encounter.subject
              Comments

              Na primeira versão não será suportado a identificação de grupos.

              Control1..?
              TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuo-1.0)
              Must Supporttrue
              40. Encounter.subject.extension
              Control0..?
              SlicingThis element introduces a set of slices on Encounter.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 42. Encounter.subject.extension:unidentifiedPatient
                Slice NameunidentifiedPatient
                ShortDados do Indivíduo Não Identificado
                Control0..?
                TypeExtension(Informações Complementares de Indivíduos Não Identificados) (Complex Extension)
                Must Supporttrue
                44. Encounter.subject.extension:unidentifiedPatient.extension
                Control3..?
                SlicingThis element introduces a set of slices on Encounter.subject.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 46. Encounter.subject.extension:unidentifiedPatient.extension:gender
                  Slice Namegender
                  Control1..?
                  Must Supporttrue
                  48. Encounter.subject.extension:unidentifiedPatient.extension:birthYear
                  Slice NamebirthYear
                  Control1..?
                  Must Supporttrue
                  50. Encounter.subject.extension:unidentifiedPatient.extension:reason
                  Slice Namereason
                  Control1..?
                  Must Supporttrue
                  52. Encounter.subject.reference
                  Control0..0
                  54. Encounter.subject.type
                  Control0..0
                  Fixed ValuePatient
                  56. Encounter.subject.identifier
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  58. Encounter.subject.identifier.use
                  Control0..0
                  60. Encounter.subject.identifier.type
                  Control0..0
                  62. Encounter.subject.identifier.system
                  Control1..?
                  64. Encounter.subject.identifier.value
                  Control1..?
                  66. Encounter.subject.identifier.period
                  Control0..0
                  68. Encounter.subject.identifier.assigner
                  Control0..0
                  70. Encounter.subject.display
                  Definition

                  Nome do indivíduo ou descrição do sujeito do Contato Assistencial quando não for um indivíduo.

                  ShortNome ou descrição do sujeito
                  Control0..0
                  72. Encounter.episodeOfCare
                  Control0..0
                  74. Encounter.basedOn
                  Control0..0
                  76. Encounter.participant
                  Definition

                  Identifica o(s) profissional(is) ou indivíduo(s) que teve(tiveram) algum tipo de participação no Contato Assistencial.

                  ShortParticipante(s) do Contato Assistencial
                  Control1..?
                  Must Supporttrue
                  Alternate NamesProfissionais do Atendimento, Profissional Responsável pela Alta
                  78. Encounter.participant.extension
                  Control1..?
                  SlicingThis element introduces a set of slices on Encounter.participant.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 80. Encounter.participant.extension:function
                    Slice Namefunction
                    Definition

                    Ocupação do profissional ou indivíduo que participou do contato assistencial.

                    Control1..1
                    TypeExtension(Ocupação) (Extension Type: CodeableConcept)
                    Must Supporttrue
                    82. Encounter.participant.extension:team
                    Slice Nameteam
                    Definition

                    Identifica a equipe de saúde responsável pelo Contato Assistencial utilizando o Identificador Nacional de Equipes.

                    ShortEquipe
                    Control0..1
                    TypeExtension(Identificador Nacional de Equipe) (Extension Type: integer)
                    Must Supporttrue
                    84. Encounter.participant.extension:isResponsable
                    Slice NameisResponsable
                    Definition

                    Representa se o profissional foi responsável pelo atendimento registrado.

                    ShortResponsável pelo Atendimento
                    Control0..1
                    TypeExtension(Responsável pelo Atendimento) (Extension Type: Choice of: boolean, Coding)
                    Is Modifierfalse
                    86. Encounter.participant.type
                    Definition

                    Responsabilidade que o profissional ou indivíduo teve durante o Contato Assistencial.

                    ShortTipo de Participação
                    Control1..1
                    BindingThe codes SHALL be taken from Reponsabilidade no Contato Assistencial
                    (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRResponsabilidadeParticipante-1.0)

                    Responsabilidade no Contato Assistencial

                    Must Supporttrue
                    88. Encounter.participant.type.coding
                    90. Encounter.participant.type.coding.system
                    Control1..?
                    92. Encounter.participant.type.coding.code
                    Control1..?
                    94. Encounter.participant.type.coding.display
                    Control0..0
                    96. Encounter.participant.type.coding.userSelected
                    Control0..0
                    98. Encounter.participant.type.text
                    Control0..0
                    100. Encounter.participant.period
                    Control0..0
                    102. Encounter.participant.individual
                    Definition

                    Identifica o profissional ou indivíduo teve alguma participação no Contato Assistencial.

                    ShortParticipante
                    Control1..?
                    TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRLotacaoProfissional-1.0, http://www.saude.gov.br/fhir/r4/StructureDefinition/BRProfissional-1.0)
                    Must Supporttrue
                    Must Support TypesNo must-support rules about the choice of types/profiles
                    104. Encounter.participant.individual.reference
                    Control0..0
                    106. Encounter.participant.individual.type
                    Control0..0
                    108. Encounter.participant.individual.identifier
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control1..?
                    110. Encounter.participant.individual.identifier.use
                    Control0..0
                    112. Encounter.participant.individual.identifier.type
                    Control0..0
                    114. Encounter.participant.individual.identifier.system
                    Control1..?
                    116. Encounter.participant.individual.identifier.value
                    Control1..?
                    118. Encounter.participant.individual.identifier.period
                    Control0..0
                    120. Encounter.participant.individual.identifier.assigner
                    Control0..0
                    122. Encounter.participant.individual.display
                    Control0..0
                    124. Encounter.appointment
                    Control0..0
                    126. Encounter.period
                    Definition

                    Data ou data/hora de adminissão e desfecho do Contato Assistencial.

                    ShortInício e Término do Contato Assistencial
                    Control1..?
                    Must Supporttrue
                    128. Encounter.period.start
                    Definition

                    Competência (mês/ano), data ou data e hora do início do Contato Assistencial.

                    ShortMomento da Admissão
                    Control1..?
                    Must Supporttrue
                    Alternate NamesData da Admissão, Data e Hora do Atendimento, Data e Hora da Admissão
                    130. Encounter.period.end
                    Definition

                    Competência (mês/ano), data ou data e hora do término do Contato Assistencial.

                    ShortMomento do Desfecho
                    Control1..?
                    Must Supporttrue
                    Alternate NamesData do Desfecho, Data e Hora da Saída da Internação
                    132. Encounter.length
                    Control0..0
                    134. Encounter.reasonCode
                    Control0..0
                    136. Encounter.reasonReference
                    Definition

                    Motivação para o Contato Assistencial acontecer.

                    ShortMotivo do Atendimento
                    Control0..1
                    TypeReference(Observação Descritiva)
                    Must Supporttrue
                    Alternate NamesMotivo do Contato Assistencial, Diangóstico Principal, Motivo da Admissão
                    138. Encounter.reasonReference.reference
                    Control1..?
                    140. Encounter.reasonReference.type
                    Control0..0
                    142. Encounter.reasonReference.identifier
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..0
                    144. Encounter.reasonReference.display
                    Control0..0
                    146. Encounter.diagnosis
                    Definition

                    Referência a diagnóstico(s) secundário(s) avaliado(s), outro(s) problema(s) avaliado(s) e/ou procedimento(s) realizado(s) durante o contato assistencial.

                    ShortDiagnósticos Secundários, Outros Problemas e Procedimentos
                    Control1..?
                    Alternate NamesProblemas/Diagnósticos Avaliados, Procedimento Executado, Procedimento Realizado
                    SlicingThis element introduces a set of slices on Encounter.diagnosis. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • profile @ condition.resolve()
                    • 148. Encounter.diagnosis:problemAndDiagnosis
                      Slice NameproblemAndDiagnosis
                      Definition

                      Informações sobre a condição de saúde, lesão, deficiência ou qualquer outra questão que afete o bem-estar físico, mental ou social de um indivíduo identificadas em um contato assistencial. (adaptado do conceito de Problema/Diagnóstico do Clinical Knowledge Manager/OpenEHR) Devem ser listados os problemas/diangnósticos avaliados durante um contato. Diagnóstico secundário é(são) a(s) condição(ões) que coexiste(m) no momento da admissão, que se desenvolve(m) durante o contato assistencial ou que afeta(m) a atenção recebida e/ou a duração do contato assistencial. (adaptado do conceito disposto no Art. 3º da Portaria SAS/MS nº 1.324, de 27 de novembro de 2014)

                      ShortDiagnósticos/Problemas Avaliados
                      Must Supporttrue
                      Alternate NamesDiagnóstico Secundário
                      150. Encounter.diagnosis:problemAndDiagnosis.condition
                      TypeReference(Problema / Diagnóstico)
                      Must Supporttrue
                      152. Encounter.diagnosis:problemAndDiagnosis.condition.reference
                      Control1..?
                      154. Encounter.diagnosis:problemAndDiagnosis.condition.type
                      Control0..0
                      156. Encounter.diagnosis:problemAndDiagnosis.condition.identifier
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..0
                      158. Encounter.diagnosis:problemAndDiagnosis.condition.display
                      Control0..0
                      160. Encounter.diagnosis:problemAndDiagnosis.use
                      BindingThe codes SHALL be taken from Classificação do papel de um problema e diagnóstico
                      (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRPapelProblemaDiagnostico)

                      Papel de um problema/diagnóstico.

                      162. Encounter.diagnosis:problemAndDiagnosis.use.coding
                      Control1..1
                      164. Encounter.diagnosis:problemAndDiagnosis.use.coding.system
                      Control1..?
                      166. Encounter.diagnosis:problemAndDiagnosis.use.coding.code
                      Control1..?
                      168. Encounter.diagnosis:problemAndDiagnosis.use.coding.userSelected
                      Control0..0
                      170. Encounter.diagnosis:problemAndDiagnosis.use.text
                      Control0..0
                      172. Encounter.diagnosis:problemAndDiagnosis.rank
                      ShortDiagnostico principal ou secundário
                      174. Encounter.diagnosis:procedure
                      Slice Nameprocedure
                      Definition

                      Ação(ões) e/ou serviço(s) de saúde realizado(s) no/para o indivíduo.

                      ShortProcedimento(s) Realizado(s)
                      Control1..?
                      Must Supporttrue
                      Alternate NamesProcedimento Executado
                      176. Encounter.diagnosis:procedure.condition
                      TypeReference(Procedimento Realizado)
                      Must Supporttrue
                      178. Encounter.diagnosis:procedure.condition.extension
                      Control1..?
                      SlicingThis element introduces a set of slices on Encounter.diagnosis.condition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 180. Encounter.diagnosis:procedure.condition.extension:financier
                        Slice Namefinancier
                        Definition

                        Agente, instituição ou entidade responsável por custear as ações e serviços de saúde.

                        Control1..1
                        TypeExtension(Financiamento) (Extension Type: CodeableConcept)
                        Must Supporttrue
                        182. Encounter.diagnosis:procedure.condition.reference
                        Control1..?
                        184. Encounter.diagnosis:procedure.condition.identifier
                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..0
                        186. Encounter.diagnosis:procedure.condition.display
                        Control0..0
                        188. Encounter.diagnosis:procedure.use
                        Control0..0
                        190. Encounter.diagnosis:procedure.rank
                        Control0..0
                        192. Encounter.account
                        Control0..0
                        194. Encounter.hospitalization
                        Control1..?
                        Must Supporttrue
                        196. Encounter.hospitalization.extension
                        Control0..?
                        SlicingThis element introduces a set of slices on Encounter.hospitalization.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 198. Encounter.hospitalization.extension:otherInformations
                          Slice NameotherInformations
                          Definition

                          Representa quaisquer outras informações descritivas relacionadas aos dados de desfecho do atendimento registrado.

                          ShortOutras Informações
                          Control0..1
                          TypeExtension(Outras Informações) (Extension Type: Annotation)
                          Is Modifierfalse
                          200. Encounter.hospitalization.preAdmissionIdentifier
                          Control0..0
                          202. Encounter.hospitalization.origin
                          Control0..0
                          204. Encounter.hospitalization.admitSource
                          Definition

                          Identifica o serviço que encaminhou o indivíduo ou a sua iniciativa/de seu responsável na busca pelo acesso ao serviço de saúde.

                          ShortProcedência
                          Control1..?
                          BindingThe codes SHALL be taken from Procedência do Contato Assistencial
                          (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRProcedencia-1.0)

                          Procedência

                          Must Supporttrue
                          206. Encounter.hospitalization.admitSource.coding
                          Control1..1
                          208. Encounter.hospitalization.admitSource.coding.system
                          Control1..?
                          210. Encounter.hospitalization.admitSource.coding.code
                          Control1..?
                          212. Encounter.hospitalization.admitSource.coding.display
                          Control0..0
                          214. Encounter.hospitalization.admitSource.coding.userSelected
                          Control0..0
                          216. Encounter.hospitalization.admitSource.text
                          Control0..0
                          218. Encounter.hospitalization.reAdmission
                          Control0..0
                          220. Encounter.hospitalization.dietPreference
                          Control0..0
                          222. Encounter.hospitalization.specialCourtesy
                          Control0..0
                          224. Encounter.hospitalization.specialArrangement
                          Control0..0
                          226. Encounter.hospitalization.destination
                          Control0..0
                          228. Encounter.hospitalization.dischargeDisposition
                          Definition

                          Caracteriza o motivo de conclusão total ou parcial do Contato Assistencial.

                          ShortMotivo de Desfecho
                          Control1..?
                          BindingThe codes SHALL be taken from Motivo do desfecho do Contato assistencial
                          (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRMotivoDesfecho-1.0)

                          Motivo do Desfecho

                          Must Supporttrue
                          Alternate NamesDesfecho da Internação
                          230. Encounter.hospitalization.dischargeDisposition.coding
                          Control1..1
                          232. Encounter.hospitalization.dischargeDisposition.coding.system
                          Control1..?
                          234. Encounter.hospitalization.dischargeDisposition.coding.code
                          Control1..?
                          236. Encounter.hospitalization.dischargeDisposition.coding.display
                          Control0..0
                          238. Encounter.hospitalization.dischargeDisposition.coding.userSelected
                          Control0..0
                          240. Encounter.hospitalization.dischargeDisposition.text
                          Control0..0
                          242. Encounter.location
                          Definition

                          Local onde o atendimento aconteceu.

                          ShortLocal de Atendimento
                          Control0..1
                          Must Supporttrue
                          244. Encounter.location.location
                          TypeReference(Local de Atendimento)
                          Must Supporttrue
                          246. Encounter.location.location.reference
                          Control1..?
                          248. Encounter.location.location.type
                          Control0..0
                          250. Encounter.location.location.identifier
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..0
                          252. Encounter.location.location.display
                          Control0..0
                          254. Encounter.location.status
                          Control0..0
                          256. Encounter.location.physicalType
                          Control0..0
                          258. Encounter.location.period
                          Control0..0
                          260. Encounter.serviceProvider
                          Definition

                          Identifica pelo número de inscrição no Cadastro Nacional de Estabelecimentos de Saúde o Estabelecimento de Saúde que realizou o Contato Assistencial.

                          ShortEstabelecimento de Saúde do Contato Assistencial
                          Control1..?
                          TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BREstabelecimentoSaude-1.0, http://www.saude.gov.br/fhir/r4/StructureDefinition/BRPessoaJuridicaProfissionalLiberal-1.0)
                          Must Supporttrue
                          Must Support TypesNo must-support rules about the choice of types/profiles
                          262. Encounter.serviceProvider.reference
                          Control0..0
                          264. Encounter.serviceProvider.type
                          Control0..0
                          266. Encounter.serviceProvider.identifier
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control1..?
                          268. Encounter.serviceProvider.identifier.use
                          Control0..0
                          270. Encounter.serviceProvider.identifier.type
                          Control0..0
                          272. Encounter.serviceProvider.identifier.system
                          Control1..?
                          274. Encounter.serviceProvider.identifier.value
                          Control1..?
                          276. Encounter.serviceProvider.identifier.period
                          Control0..0
                          278. Encounter.serviceProvider.identifier.assigner
                          Control0..0
                          280. Encounter.serviceProvider.display
                          Control0..0
                          282. Encounter.partOf
                          Definition

                          Permite referenciar outro Contato Assistencial que tenha dado sequência a este, como por exemplo, um indivíduo realiza, em um mesmo Estabelecimento de Saúde, um Contato Assistencial que seja de Modalidade Assistencial Atenção à Urgência/Emergência, e necessite ser internado, dando continuidade em um Contato Assistencial de Atenção Hospitalar. Neste exemplo, este elemento seria utilizado no Contato Assistencial de Atenção Hospitalar, que faria referência ao Contato Assistencial de Atenção à Urgência/Emergência.

                          ShortContato Assistencial anterior
                          TypeReference(Contato Assistencial)
                          Must Supporttrue
                          284. Encounter.partOf.reference
                          Control1..?
                          286. Encounter.partOf.type
                          Control0..0
                          288. Encounter.partOf.identifier
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..0
                          290. Encounter.partOf.display
                          Control0..0

                          Guidance on how to interpret the contents of this table can be found here

                          0. Encounter
                          Definition

                          Atenção à saúde dispensada a um indivíduo em uma modalidade assistencial, de forma ininterrupta e em um mesmo estabelecimento de saúde.

                          ShortContato Assistencial
                          Control0..*
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Alternate NamesVisit, Atendimento, Visita, Internação, Consulta, Atendimento Ambulatorial
                          Invariantsdom-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 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                          dom-6: A resource should have narrative for robust management (text.`div`.exists())
                          2. Encounter.id
                          Definition

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

                          ShortLogical id of this artifact
                          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.

                          Control0..1
                          Typeid
                          Is Modifierfalse
                          Summarytrue
                          4. Encounter.meta
                          Definition

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

                          ShortMetadata about the resource
                          Control0..1
                          TypeMeta
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          6. Encounter.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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                          ShortA set of rules under which this content was created
                          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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                          Control0..1
                          Typeuri
                          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          8. Encounter.language
                          Definition

                          The base language in which the resource is written.

                          ShortLanguage of the resource content
                          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).

                          Control0..1
                          BindingThe codes SHOULD be taken from CommonLanguages
                          (preferred to http://hl7.org/fhir/ValueSet/languages)

                          A human language.

                          Additional BindingsPurpose
                          AllLanguagesMax Binding
                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          10. Encounter.text
                          Definition

                          A human-readable narrative that contains a summary of the resource and can 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.

                          ShortText summary of the resource, for human interpretation
                          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 information is added later.

                          Control0..1
                          TypeNarrative
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesnarrative, html, xhtml, display
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          12. Encounter.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.

                          ShortContained, inline 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                          Control0..*
                          TypeResource
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesinline resources, anonymous resources, contained resources
                          14. Encounter.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          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.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          16. Encounter.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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          ShortExtensions that cannot be ignored
                          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.

                          Control0..*
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                          Summaryfalse
                          Requirements

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          18. Encounter.identifier
                          Definition

                          Identifier(s) by which this encounter is known.

                          ShortIdentifier(s) by which this encounter is known
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..0
                          TypeIdentifier
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          20. Encounter.status
                          Definition

                          Indica o estado que o contato assistencial se encontra quando é informado para a RNDS.

                          Shortfinished | entered-in-error
                          Comments

                          Na RNDS os contatos assistenciais somente são informados após terem sido finalizados, portanto somente a opção finished pode ser utilizada, ou entered-in-error, quando o contato assistencial foi enviado com erro.

                          Control1..1
                          BindingThe codes SHALL be taken from Estado do Contato Assistencial
                          (required to http://www.saude.gov.br/fhir/r4/ValueSet/BREstadoContatoAssistencial-1.0)

                          Estado do Contato Assistencial

                          Typecode
                          Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          22. Encounter.statusHistory
                          Definition

                          The status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them.

                          ShortList of past encounter statuses
                          Comments

                          The current status is always found in the current version of the resource, not the status history.

                          Control0..0
                          TypeBackboneElement
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          29. Encounter.class
                          Definition

                          Classifica os contatos assistenciais de acordo com as especificidades do modo, local e duração do atendimento. Referência: https://rts.saude.gov.br/#/modalidade-assistencial

                          ShortModalidade Assistencial
                          Control1..1
                          BindingThe codes SHALL be taken from Modalidade Assistencial
                          (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRModalidadeAssistencial-1.0)

                          Modalidade Assistencial

                          TypeCoding
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          LabelModalidade Assistencial
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          31. Encounter.class.id
                          Definition

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

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          33. Encounter.class.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          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.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on Encounter.class.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 35. Encounter.class.system
                            Definition

                            The identification of the code system that defines the meaning of the symbol in the code.

                            ShortIdentity of the terminology system
                            Comments

                            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                            Control1..1
                            Typeuri
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need to be unambiguous about the source of the definition of the symbol.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            37. Encounter.class.version
                            Definition

                            The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                            ShortVersion of the system - if relevant
                            Comments

                            Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                            NoteThis is a business version Id, not a resource version Id (see discussion)
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            39. Encounter.class.code
                            Definition

                            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                            ShortSymbol in syntax defined by the system
                            Control1..1
                            Typecode
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need to refer to a particular code in the system.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            41. Encounter.class.display
                            Definition

                            A representation of the meaning of the code in the system, following the rules of the system.

                            ShortRepresentation defined by the system
                            Control0..0
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            43. Encounter.class.userSelected
                            Definition

                            Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                            ShortIf this coding was chosen directly by the user
                            Comments

                            Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                            Control0..0
                            Typeboolean
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            45. Encounter.classHistory
                            Definition

                            The class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transitions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kind of discharge from emergency to inpatient.

                            ShortList of past encounter classes
                            Control0..0
                            TypeBackboneElement
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            52. Encounter.type
                            Definition

                            Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).

                            ShortSpecific type of encounter
                            Comments

                            Since there are many ways to further classify encounters, this element is 0..*.

                            Control0..0
                            BindingFor example codes, see EncounterType
                            (example to http://hl7.org/fhir/ValueSet/encounter-type)

                            The type of encounter.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            54. Encounter.serviceType
                            Definition

                            Broad categorization of the service that is to be provided (e.g. cardiology).

                            ShortSpecific type of service
                            Control0..0
                            BindingFor example codes, see ServiceType
                            (example to http://hl7.org/fhir/ValueSet/service-type)

                            Broad categorization of the service that is to be provided.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            56. Encounter.priority
                            Definition

                            Identifica o contato assistencial de acordo com a prioridade de sua realização. Referência: https://rts.saude.gov.br/#/carater-atendimento

                            ShortCaráter do Atendimento
                            Control1..1
                            BindingThe codes SHALL be taken from Caráter de atendimento do Contato Assistencial
                            (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRCaraterAtendimento-1.0)

                            Identifica o contato assistencial de acordo com a prioridade de sua realização.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            LabelCaráter do Atendimento
                            Alternate NamesCaráter de Atendimento, Caráter da Internação
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            58. Encounter.priority.id
                            Definition

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

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            60. Encounter.priority.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            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.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on Encounter.priority.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 62. Encounter.priority.coding
                              Definition

                              A reference to a code defined by a terminology system.

                              ShortCode defined by a terminology system
                              Comments

                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                              Control1..1
                              TypeCoding
                              Is Modifierfalse
                              Summarytrue
                              Requirements

                              Allows for alternative encodings within a code system, and translations to other code systems.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              64. Encounter.priority.coding.id
                              Definition

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

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              66. Encounter.priority.coding.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              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.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on Encounter.priority.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 68. Encounter.priority.coding.system
                                Definition

                                The identification of the code system that defines the meaning of the symbol in the code.

                                ShortIdentity of the terminology system
                                Comments

                                The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                Control1..1
                                Typeuri
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Need to be unambiguous about the source of the definition of the symbol.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                70. Encounter.priority.coding.version
                                Definition

                                The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                ShortVersion of the system - if relevant
                                Comments

                                Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                NoteThis is a business version Id, not a resource version Id (see discussion)
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                72. Encounter.priority.coding.code
                                Definition

                                A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                ShortSymbol in syntax defined by the system
                                Control1..1
                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Need to refer to a particular code in the system.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                74. Encounter.priority.coding.display
                                Definition

                                A representation of the meaning of the code in the system, following the rules of the system.

                                ShortRepresentation defined by the system
                                Control0..0
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                76. Encounter.priority.coding.userSelected
                                Definition

                                Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                ShortIf this coding was chosen directly by the user
                                Comments

                                Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                Control0..0
                                Typeboolean
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                78. Encounter.priority.text
                                Definition

                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                ShortPlain text representation of the concept
                                Comments

                                Very often the text is the same as a displayName of one of the codings.

                                Control0..0
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                80. Encounter.subject
                                Definition

                                The patient or group present at the encounter.

                                ShortThe patient or group present at the encounter
                                Comments

                                Na primeira versão não será suportado a identificação de grupos.

                                Control1..1
                                TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuo-1.0)
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Alternate Namespatient
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                82. Encounter.subject.id
                                Definition

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                84. Encounter.subject.extension
                                Definition

                                An Extension

                                ShortExtension
                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Encounter.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 86. Encounter.subject.extension:unidentifiedPatient
                                  Slice NameunidentifiedPatient
                                  Definition

                                  Informações demográficas básicas e justificativa dos indivíduos que não podem ser identificados por razões clínicas ou sociais, conforme legislação brasileira, com finalidade estatística.

                                  ShortDados do Indivíduo Não Identificado
                                  Control0..*
                                  TypeExtension(Informações Complementares de Indivíduos Não Identificados) (Complex Extension)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  88. Encounter.subject.extension:unidentifiedPatient.id
                                  Definition

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

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  90. Encounter.subject.extension:unidentifiedPatient.extension
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Control3..3
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on Encounter.subject.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 92. Encounter.subject.extension:unidentifiedPatient.extension:gender
                                    Slice Namegender
                                    Definition

                                    An Extension

                                    ShortExtension
                                    Control1..1
                                    TypeExtension
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    94. Encounter.subject.extension:unidentifiedPatient.extension:gender.id
                                    Definition

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

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    96. Encounter.subject.extension:unidentifiedPatient.extension:gender.extension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                    ShortAdditional content defined by implementations
                                    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.

                                    Control0..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on Encounter.subject.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 98. Encounter.subject.extension:unidentifiedPatient.extension:gender.url
                                      Definition

                                      Source of the definition for the extension code - a logical name or a URL.

                                      Shortidentifies the meaning of the extension
                                      Comments

                                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                      Control1..1
                                      Typeuri
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      Fixed Valuegender
                                      100. Encounter.subject.extension:unidentifiedPatient.extension:gender.value[x]
                                      Definition

                                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                      ShortValue of extension
                                      Control1..1
                                      Typecode
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      102. Encounter.subject.extension:unidentifiedPatient.extension:birthYear
                                      Slice NamebirthYear
                                      Definition

                                      An Extension

                                      ShortExtension
                                      Control1..1
                                      TypeExtension
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      104. Encounter.subject.extension:unidentifiedPatient.extension:birthYear.id
                                      Definition

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

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      106. Encounter.subject.extension:unidentifiedPatient.extension:birthYear.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      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.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on Encounter.subject.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 108. Encounter.subject.extension:unidentifiedPatient.extension:birthYear.url
                                        Definition

                                        Source of the definition for the extension code - a logical name or a URL.

                                        Shortidentifies the meaning of the extension
                                        Comments

                                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                        Control1..1
                                        Typeuri
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        Fixed ValuebirthYear
                                        110. Encounter.subject.extension:unidentifiedPatient.extension:birthYear.value[x]
                                        Definition

                                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                        ShortValue of extension
                                        Control1..1
                                        Typedate
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        112. Encounter.subject.extension:unidentifiedPatient.extension:reason
                                        Slice Namereason
                                        Definition

                                        An Extension

                                        ShortExtension
                                        Control1..1
                                        TypeExtension
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        114. Encounter.subject.extension:unidentifiedPatient.extension:reason.id
                                        Definition

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

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        116. Encounter.subject.extension:unidentifiedPatient.extension:reason.extension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                        ShortAdditional content defined by implementations
                                        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.

                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingThis element introduces a set of slices on Encounter.subject.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 118. Encounter.subject.extension:unidentifiedPatient.extension:reason.url
                                          Definition

                                          Source of the definition for the extension code - a logical name or a URL.

                                          Shortidentifies the meaning of the extension
                                          Comments

                                          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                          Control1..1
                                          Typeuri
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          Fixed Valuereason
                                          120. Encounter.subject.extension:unidentifiedPatient.extension:reason.value[x]
                                          Definition

                                          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                          ShortValue of extension
                                          Control1..1
                                          TypeCodeableConcept
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          122. Encounter.subject.extension:unidentifiedPatient.url
                                          Definition

                                          Source of the definition for the extension code - a logical name or a URL.

                                          Shortidentifies the meaning of the extension
                                          Comments

                                          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                          Control1..1
                                          Typeuri
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          Fixed Valuehttp://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuoNaoIdentificado-1.0
                                          124. Encounter.subject.extension:unidentifiedPatient.value[x]
                                          Definition

                                          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                          ShortValue of extension
                                          Control0..0
                                          TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          126. Encounter.subject.reference
                                          Definition

                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                          ShortLiteral reference, Relative, internal or absolute URL
                                          Comments

                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                          Control0..0
                                          This element is affected by the following invariants: ref-1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          128. Encounter.subject.type
                                          Definition

                                          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                          ShortType the reference refers to (e.g. "Patient")
                                          Comments

                                          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                          Control0..0
                                          BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                          (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                          Aa resource (or, for logical models, the URI of the logical model).

                                          Typeuri
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Fixed ValuePatient
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          130. Encounter.subject.identifier
                                          Definition

                                          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                          ShortLogical reference, when literal reference is not known
                                          Comments

                                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Control0..1
                                          TypeIdentifier
                                          Is Modifierfalse
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          132. Encounter.subject.identifier.id
                                          Definition

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

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          134. Encounter.subject.identifier.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          SlicingThis element introduces a set of slices on Encounter.subject.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 136. Encounter.subject.identifier.use
                                            Definition

                                            The purpose of this identifier.

                                            Shortusual | official | temp | secondary | old (If known)
                                            Comments

                                            Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                            Control0..0
                                            BindingThe codes SHALL be taken from IdentifierUse
                                            (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                            Identifies the purpose for this identifier, if known .

                                            Typecode
                                            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

                                            Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            138. Encounter.subject.identifier.type
                                            Definition

                                            A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                            ShortDescription of identifier
                                            Comments

                                            This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                            Control0..0
                                            BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                            (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                                            A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summarytrue
                                            Requirements

                                            Allows users to make use of identifiers when the identifier system is not known.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            140. Encounter.subject.identifier.system
                                            Definition

                                            Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                            ShortThe namespace for the identifier value
                                            Comments

                                            Identifier.system is always case sensitive.

                                            Control1..1
                                            Typeuri
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

                                            There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                            Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            142. Encounter.subject.identifier.value
                                            Definition

                                            The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                            ShortThe value that is unique
                                            Comments

                                            If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                            Control1..1
                                            Typestring
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Example<br/><b>General</b>:123456
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            144. Encounter.subject.identifier.period
                                            Definition

                                            Time period during which identifier is/was valid for use.

                                            ShortTime period when id is/was valid for use
                                            Control0..0
                                            TypePeriod
                                            Is Modifierfalse
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            146. Encounter.subject.identifier.assigner
                                            Definition

                                            Organization that issued/manages the identifier.

                                            ShortOrganization that issued id (may be just text)
                                            Comments

                                            The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                            Control0..0
                                            TypeReference(Organization)
                                            Is Modifierfalse
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            148. Encounter.subject.display
                                            Definition

                                            Nome do indivíduo ou descrição do sujeito do Contato Assistencial quando não for um indivíduo.

                                            ShortNome ou descrição do sujeito
                                            Comments

                                            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                            Control0..0
                                            Typestring
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            150. Encounter.episodeOfCare
                                            Definition

                                            Where a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years).

                                            ShortEpisode(s) of care that this encounter should be recorded against
                                            Control0..0
                                            TypeReference(EpisodeOfCare)
                                            Is Modifierfalse
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            152. Encounter.basedOn
                                            Definition

                                            The request this encounter satisfies (e.g. incoming referral or procedure request).

                                            ShortThe ServiceRequest that initiated this encounter
                                            Control0..0
                                            TypeReference(ServiceRequest)
                                            Is Modifierfalse
                                            Summaryfalse
                                            Alternate NamesincomingReferral
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            154. Encounter.participant
                                            Definition

                                            Identifica o(s) profissional(is) ou indivíduo(s) que teve(tiveram) algum tipo de participação no Contato Assistencial.

                                            ShortParticipante(s) do Contato Assistencial
                                            Control1..*
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summarytrue
                                            Alternate NamesProfissionais do Atendimento, Profissional Responsável pela Alta
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            156. Encounter.participant.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            158. Encounter.participant.extension
                                            Definition

                                            An Extension

                                            ShortExtension
                                            Control1..*
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            SlicingThis element introduces a set of slices on Encounter.participant.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 160. Encounter.participant.extension:function
                                              Slice Namefunction
                                              Definition

                                              Ocupação do profissional ou indivíduo que participou do contato assistencial.

                                              ShortOcupação
                                              Control1..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(Ocupação) (Extension Type: CodeableConcept)
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              162. Encounter.participant.extension:team
                                              Slice Nameteam
                                              Definition

                                              Identifica a equipe de saúde responsável pelo Contato Assistencial utilizando o Identificador Nacional de Equipes.

                                              ShortEquipe
                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(Identificador Nacional de Equipe) (Extension Type: integer)
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              164. Encounter.participant.extension:isResponsable
                                              Slice NameisResponsable
                                              Definition

                                              Representa se o profissional foi responsável pelo atendimento registrado.

                                              ShortResponsável pelo Atendimento
                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(Responsável pelo Atendimento) (Extension Type: Choice of: boolean, Coding)
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              166. Encounter.participant.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              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.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              168. Encounter.participant.type
                                              Definition

                                              Responsabilidade que o profissional ou indivíduo teve durante o Contato Assistencial.

                                              ShortTipo de Participação
                                              Comments

                                              The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

                                              Control1..1
                                              BindingThe codes SHALL be taken from Reponsabilidade no Contato Assistencial
                                              (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRResponsabilidadeParticipante-1.0)

                                              Responsabilidade no Contato Assistencial

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              170. Encounter.participant.type.id
                                              Definition

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

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              172. Encounter.participant.type.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              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.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              SlicingThis element introduces a set of slices on Encounter.participant.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 174. Encounter.participant.type.coding
                                                Definition

                                                A reference to a code defined by a terminology system.

                                                ShortCode defined by a terminology system
                                                Comments

                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                Control0..*
                                                TypeCoding
                                                Is Modifierfalse
                                                Summarytrue
                                                Requirements

                                                Allows for alternative encodings within a code system, and translations to other code systems.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                176. Encounter.participant.type.coding.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                178. Encounter.participant.type.coding.extension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                ShortAdditional content defined by implementations
                                                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.

                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                SlicingThis element introduces a set of slices on Encounter.participant.type.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 180. Encounter.participant.type.coding.system
                                                  Definition

                                                  The identification of the code system that defines the meaning of the symbol in the code.

                                                  ShortIdentity of the terminology system
                                                  Comments

                                                  The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                                  Control1..1
                                                  Typeuri
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

                                                  Need to be unambiguous about the source of the definition of the symbol.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  182. Encounter.participant.type.coding.version
                                                  Definition

                                                  The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                  ShortVersion of the system - if relevant
                                                  Comments

                                                  Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                  NoteThis is a business version Id, not a resource version Id (see discussion)
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  184. Encounter.participant.type.coding.code
                                                  Definition

                                                  A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                  ShortSymbol in syntax defined by the system
                                                  Control1..1
                                                  Typecode
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

                                                  Need to refer to a particular code in the system.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  186. Encounter.participant.type.coding.display
                                                  Definition

                                                  A representation of the meaning of the code in the system, following the rules of the system.

                                                  ShortRepresentation defined by the system
                                                  Control0..0
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

                                                  Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  188. Encounter.participant.type.coding.userSelected
                                                  Definition

                                                  Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                  ShortIf this coding was chosen directly by the user
                                                  Comments

                                                  Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                  Control0..0
                                                  Typeboolean
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

                                                  This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  190. Encounter.participant.type.text
                                                  Definition

                                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                  ShortPlain text representation of the concept
                                                  Comments

                                                  Very often the text is the same as a displayName of one of the codings.

                                                  Control0..0
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

                                                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  192. Encounter.participant.period
                                                  Definition

                                                  The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.

                                                  ShortPeriod of time during the encounter that the participant participated
                                                  Control0..0
                                                  TypePeriod
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  194. Encounter.participant.individual
                                                  Definition

                                                  Identifica o profissional ou indivíduo teve alguma participação no Contato Assistencial.

                                                  ShortParticipante
                                                  Control1..1
                                                  TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRLotacaoProfissional-1.0, http://www.saude.gov.br/fhir/r4/StructureDefinition/BRProfissional-1.0)
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  196. Encounter.participant.individual.id
                                                  Definition

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

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  198. Encounter.participant.individual.extension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                  ShortAdditional content defined by implementations
                                                  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.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Alternate Namesextensions, user content
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on Encounter.participant.individual.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 200. Encounter.participant.individual.reference
                                                    Definition

                                                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                    ShortLiteral reference, Relative, internal or absolute URL
                                                    Comments

                                                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                    Control0..0
                                                    This element is affected by the following invariants: ref-1
                                                    Typestring
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    202. Encounter.participant.individual.type
                                                    Definition

                                                    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                    ShortType the reference refers to (e.g. "Patient")
                                                    Comments

                                                    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                    Control0..0
                                                    BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                    (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                    Aa resource (or, for logical models, the URI of the logical model).

                                                    Typeuri
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    204. Encounter.participant.individual.identifier
                                                    Definition

                                                    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                    ShortLogical reference, when literal reference is not known
                                                    Comments

                                                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                                    Control1..1
                                                    TypeIdentifier
                                                    Is Modifierfalse
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    206. Encounter.participant.individual.identifier.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    208. Encounter.participant.individual.identifier.extension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                    ShortAdditional content defined by implementations
                                                    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.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    SlicingThis element introduces a set of slices on Encounter.participant.individual.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 210. Encounter.participant.individual.identifier.use
                                                      Definition

                                                      The purpose of this identifier.

                                                      Shortusual | official | temp | secondary | old (If known)
                                                      Comments

                                                      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                                      Control0..0
                                                      BindingThe codes SHALL be taken from IdentifierUse
                                                      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                                      Identifies the purpose for this identifier, if known .

                                                      Typecode
                                                      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      212. Encounter.participant.individual.identifier.type
                                                      Definition

                                                      A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                                      ShortDescription of identifier
                                                      Comments

                                                      This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                                      Control0..0
                                                      BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                      (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                                                      A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Requirements

                                                      Allows users to make use of identifiers when the identifier system is not known.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      214. Encounter.participant.individual.identifier.system
                                                      Definition

                                                      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                                      ShortThe namespace for the identifier value
                                                      Comments

                                                      Identifier.system is always case sensitive.

                                                      Control1..1
                                                      Typeuri
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                                      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      216. Encounter.participant.individual.identifier.value
                                                      Definition

                                                      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                                      ShortThe value that is unique
                                                      Comments

                                                      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                                      Control1..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Example<br/><b>General</b>:123456
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      218. Encounter.participant.individual.identifier.period
                                                      Definition

                                                      Time period during which identifier is/was valid for use.

                                                      ShortTime period when id is/was valid for use
                                                      Control0..0
                                                      TypePeriod
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      220. Encounter.participant.individual.identifier.assigner
                                                      Definition

                                                      Organization that issued/manages the identifier.

                                                      ShortOrganization that issued id (may be just text)
                                                      Comments

                                                      The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                                      Control0..0
                                                      TypeReference(Organization)
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      222. Encounter.participant.individual.display
                                                      Definition

                                                      Plain text narrative that identifies the resource in addition to the resource reference.

                                                      ShortText alternative for the resource
                                                      Comments

                                                      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                      Control0..0
                                                      Typestring
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      224. Encounter.appointment
                                                      Definition

                                                      The appointment that scheduled this encounter.

                                                      ShortThe appointment that scheduled this encounter
                                                      Control0..0
                                                      TypeReference(Appointment)
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      226. Encounter.period
                                                      Definition

                                                      Data ou data/hora de adminissão e desfecho do Contato Assistencial.

                                                      ShortInício e Término do Contato Assistencial
                                                      Comments

                                                      If not (yet) known, the end of the Period may be omitted.

                                                      Control1..1
                                                      TypePeriod
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      228. Encounter.period.id
                                                      Definition

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

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      230. Encounter.period.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      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.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      SlicingThis element introduces a set of slices on Encounter.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 232. Encounter.period.start
                                                        Definition

                                                        Competência (mês/ano), data ou data e hora do início do Contato Assistencial.

                                                        ShortMomento da Admissão
                                                        Comments

                                                        If the low element is missing, the meaning is that the low boundary is not known.

                                                        Control1..1
                                                        This element is affected by the following invariants: per-1
                                                        TypedateTime
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Alternate NamesData da Admissão, Data e Hora do Atendimento, Data e Hora da Admissão
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        234. Encounter.period.end
                                                        Definition

                                                        Competência (mês/ano), data ou data e hora do término do Contato Assistencial.

                                                        ShortMomento do Desfecho
                                                        Comments

                                                        The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                                        Control1..1
                                                        This element is affected by the following invariants: per-1
                                                        TypedateTime
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Alternate NamesData do Desfecho, Data e Hora da Saída da Internação
                                                        Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        236. Encounter.length
                                                        Definition

                                                        Quantity of time the encounter lasted. This excludes the time during leaves of absence.

                                                        ShortQuantity of time the encounter lasted (less time absent)
                                                        Comments

                                                        May differ from the time the Encounter.period lasted because of leave of absence.

                                                        Control0..0
                                                        TypeDuration
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        238. Encounter.reasonCode
                                                        Definition

                                                        Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.

                                                        ShortCoded reason the encounter takes place
                                                        Comments

                                                        For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

                                                        Control0..0
                                                        BindingThe codes SHOULD be taken from EncounterReasonCodes
                                                        (preferred to http://hl7.org/fhir/ValueSet/encounter-reason)

                                                        Reason why the encounter takes place.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summarytrue
                                                        Alternate NamesIndication, Admission diagnosis
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        240. Encounter.reasonReference
                                                        Definition

                                                        Motivação para o Contato Assistencial acontecer.

                                                        ShortMotivo do Atendimento
                                                        Comments

                                                        For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

                                                        Control0..1
                                                        TypeReference(Observação Descritiva)
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Alternate NamesIndication, Admission diagnosis, Motivo do Contato Assistencial, Diangóstico Principal, Motivo da Admissão
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        242. Encounter.reasonReference.id
                                                        Definition

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

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        244. Encounter.reasonReference.extension
                                                        Definition

                                                        May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                        ShortAdditional content defined by implementations
                                                        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.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on Encounter.reasonReference.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 246. Encounter.reasonReference.reference
                                                          Definition

                                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                          ShortLiteral reference, Relative, internal or absolute URL
                                                          Comments

                                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                          Control1..1
                                                          This element is affected by the following invariants: ref-1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          248. Encounter.reasonReference.type
                                                          Definition

                                                          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                          ShortType the reference refers to (e.g. "Patient")
                                                          Comments

                                                          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                          Control0..0
                                                          BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                          (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                          Aa resource (or, for logical models, the URI of the logical model).

                                                          Typeuri
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          250. Encounter.reasonReference.identifier
                                                          Definition

                                                          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                          ShortLogical reference, when literal reference is not known
                                                          Comments

                                                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                          Control0..0
                                                          TypeIdentifier
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          252. Encounter.reasonReference.display
                                                          Definition

                                                          Plain text narrative that identifies the resource in addition to the resource reference.

                                                          ShortText alternative for the resource
                                                          Comments

                                                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                          Control0..0
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          254. Encounter.diagnosis
                                                          Definition

                                                          Referência a diagnóstico(s) secundário(s) avaliado(s), outro(s) problema(s) avaliado(s) e/ou procedimento(s) realizado(s) durante o contato assistencial.

                                                          ShortDiagnósticos Secundários, Outros Problemas e Procedimentos
                                                          Control1..*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Alternate NamesProblemas/Diagnósticos Avaliados, Procedimento Executado, Procedimento Realizado
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          SlicingThis element introduces a set of slices on Encounter.diagnosis. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • profile @ condition.resolve()
                                                          • 256. Encounter.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.

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            258. Encounter.diagnosis.extension
                                                            Definition

                                                            May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                            ShortAdditional content defined by implementations
                                                            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.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Alternate Namesextensions, user content
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            260. Encounter.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                            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.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                            Summarytrue
                                                            Requirements

                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                            Alternate Namesextensions, user content, modifiers
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            262. Encounter.diagnosis.condition
                                                            Definition

                                                            Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.

                                                            ShortThe diagnosis or procedure relevant to the encounter
                                                            Comments

                                                            For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

                                                            Control1..1
                                                            TypeReference(Condition, Procedure)
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Alternate NamesAdmission diagnosis, discharge diagnosis, indication
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            264. Encounter.diagnosis.use
                                                            Definition

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

                                                            ShortRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
                                                            Control0..1
                                                            BindingThe codes SHOULD be taken from DiagnosisRole
                                                            (preferred to http://hl7.org/fhir/ValueSet/diagnosis-role)

                                                            The type of diagnosis this condition represents.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            266. Encounter.diagnosis.rank
                                                            Definition

                                                            Ranking of the diagnosis (for each role type).

                                                            ShortRanking of the diagnosis (for each role type)
                                                            Control0..1
                                                            TypepositiveInt
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            268. Encounter.diagnosis:problemAndDiagnosis
                                                            Slice NameproblemAndDiagnosis
                                                            Definition

                                                            Informações sobre a condição de saúde, lesão, deficiência ou qualquer outra questão que afete o bem-estar físico, mental ou social de um indivíduo identificadas em um contato assistencial. (adaptado do conceito de Problema/Diagnóstico do Clinical Knowledge Manager/OpenEHR) Devem ser listados os problemas/diangnósticos avaliados durante um contato. Diagnóstico secundário é(são) a(s) condição(ões) que coexiste(m) no momento da admissão, que se desenvolve(m) durante o contato assistencial ou que afeta(m) a atenção recebida e/ou a duração do contato assistencial. (adaptado do conceito disposto no Art. 3º da Portaria SAS/MS nº 1.324, de 27 de novembro de 2014)

                                                            ShortDiagnósticos/Problemas Avaliados
                                                            Control0..*
                                                            TypeBackboneElement
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Summarytrue
                                                            Alternate NamesDiagnóstico Secundário
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            270. Encounter.diagnosis:problemAndDiagnosis.id
                                                            Definition

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

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            272. Encounter.diagnosis:problemAndDiagnosis.extension
                                                            Definition

                                                            May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                            ShortAdditional content defined by implementations
                                                            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.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Alternate Namesextensions, user content
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            274. Encounter.diagnosis:problemAndDiagnosis.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                            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.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                            Summarytrue
                                                            Requirements

                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                            Alternate Namesextensions, user content, modifiers
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            276. Encounter.diagnosis:problemAndDiagnosis.condition
                                                            Definition

                                                            Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.

                                                            ShortThe diagnosis or procedure relevant to the encounter
                                                            Comments

                                                            For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

                                                            Control1..1
                                                            TypeReference(Problema / Diagnóstico)
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Summarytrue
                                                            Alternate NamesAdmission diagnosis, discharge diagnosis, indication
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            278. Encounter.diagnosis:problemAndDiagnosis.condition.id
                                                            Definition

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

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            280. Encounter.diagnosis:problemAndDiagnosis.condition.extension
                                                            Definition

                                                            May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                            ShortAdditional content defined by implementations
                                                            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.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Alternate Namesextensions, user content
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            SlicingThis element introduces a set of slices on Encounter.diagnosis.condition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 282. Encounter.diagnosis:problemAndDiagnosis.condition.reference
                                                              Definition

                                                              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                              ShortLiteral reference, Relative, internal or absolute URL
                                                              Comments

                                                              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                              Control1..1
                                                              This element is affected by the following invariants: ref-1
                                                              Typestring
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              284. Encounter.diagnosis:problemAndDiagnosis.condition.type
                                                              Definition

                                                              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                              ShortType the reference refers to (e.g. "Patient")
                                                              Comments

                                                              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                              Control0..0
                                                              BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                              (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                              Aa resource (or, for logical models, the URI of the logical model).

                                                              Typeuri
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              286. Encounter.diagnosis:problemAndDiagnosis.condition.identifier
                                                              Definition

                                                              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                              ShortLogical reference, when literal reference is not known
                                                              Comments

                                                              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                              NoteThis is a business identifier, not a resource identifier (see discussion)
                                                              Control0..0
                                                              TypeIdentifier
                                                              Is Modifierfalse
                                                              Summarytrue
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              288. Encounter.diagnosis:problemAndDiagnosis.condition.display
                                                              Definition

                                                              Plain text narrative that identifies the resource in addition to the resource reference.

                                                              ShortText alternative for the resource
                                                              Comments

                                                              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                              Control0..0
                                                              Typestring
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              290. Encounter.diagnosis:problemAndDiagnosis.use
                                                              Definition

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

                                                              ShortRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
                                                              Control0..1
                                                              BindingThe codes SHALL be taken from Classificação do papel de um problema e diagnóstico
                                                              (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRPapelProblemaDiagnostico)

                                                              Papel de um problema/diagnóstico.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              292. Encounter.diagnosis:problemAndDiagnosis.use.id
                                                              Definition

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

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              Typestring
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              294. Encounter.diagnosis:problemAndDiagnosis.use.extension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                              ShortAdditional content defined by implementations
                                                              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.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Alternate Namesextensions, user content
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              SlicingThis element introduces a set of slices on Encounter.diagnosis.use.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 296. Encounter.diagnosis:problemAndDiagnosis.use.coding
                                                                Definition

                                                                A reference to a code defined by a terminology system.

                                                                ShortCode defined by a terminology system
                                                                Comments

                                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                Control1..1
                                                                TypeCoding
                                                                Is Modifierfalse
                                                                Summarytrue
                                                                Requirements

                                                                Allows for alternative encodings within a code system, and translations to other code systems.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                298. Encounter.diagnosis:problemAndDiagnosis.use.coding.id
                                                                Definition

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

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                300. Encounter.diagnosis:problemAndDiagnosis.use.coding.extension
                                                                Definition

                                                                May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                ShortAdditional content defined by implementations
                                                                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.

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Alternate Namesextensions, user content
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                SlicingThis element introduces a set of slices on Encounter.diagnosis.use.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 302. Encounter.diagnosis:problemAndDiagnosis.use.coding.system
                                                                  Definition

                                                                  The identification of the code system that defines the meaning of the symbol in the code.

                                                                  ShortIdentity of the terminology system
                                                                  Comments

                                                                  The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                                                  Control1..1
                                                                  Typeuri
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Requirements

                                                                  Need to be unambiguous about the source of the definition of the symbol.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  304. Encounter.diagnosis:problemAndDiagnosis.use.coding.version
                                                                  Definition

                                                                  The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                                  ShortVersion of the system - if relevant
                                                                  Comments

                                                                  Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                                  NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  306. Encounter.diagnosis:problemAndDiagnosis.use.coding.code
                                                                  Definition

                                                                  A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                                  ShortSymbol in syntax defined by the system
                                                                  Control1..1
                                                                  Typecode
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Requirements

                                                                  Need to refer to a particular code in the system.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  308. Encounter.diagnosis:problemAndDiagnosis.use.coding.display
                                                                  Definition

                                                                  A representation of the meaning of the code in the system, following the rules of the system.

                                                                  ShortRepresentation defined by the system
                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Requirements

                                                                  Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  310. Encounter.diagnosis:problemAndDiagnosis.use.coding.userSelected
                                                                  Definition

                                                                  Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                                  ShortIf this coding was chosen directly by the user
                                                                  Comments

                                                                  Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                                  Control0..0
                                                                  Typeboolean
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Requirements

                                                                  This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  312. Encounter.diagnosis:problemAndDiagnosis.use.text
                                                                  Definition

                                                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                  ShortPlain text representation of the concept
                                                                  Comments

                                                                  Very often the text is the same as a displayName of one of the codings.

                                                                  Control0..0
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Requirements

                                                                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  314. Encounter.diagnosis:problemAndDiagnosis.rank
                                                                  Definition

                                                                  Ranking of the diagnosis (for each role type).

                                                                  ShortDiagnostico principal ou secundário
                                                                  Control0..1
                                                                  TypepositiveInt
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  316. Encounter.diagnosis:procedure
                                                                  Slice Nameprocedure
                                                                  Definition

                                                                  Ação(ões) e/ou serviço(s) de saúde realizado(s) no/para o indivíduo.

                                                                  ShortProcedimento(s) Realizado(s)
                                                                  Control1..*
                                                                  TypeBackboneElement
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summarytrue
                                                                  Alternate NamesProcedimento Executado
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  318. Encounter.diagnosis:procedure.id
                                                                  Definition

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

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  320. Encounter.diagnosis:procedure.extension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                  ShortAdditional content defined by implementations
                                                                  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.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Alternate Namesextensions, user content
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  322. Encounter.diagnosis:procedure.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                  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.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                  Summarytrue
                                                                  Requirements

                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                  Alternate Namesextensions, user content, modifiers
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  324. Encounter.diagnosis:procedure.condition
                                                                  Definition

                                                                  Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.

                                                                  ShortThe diagnosis or procedure relevant to the encounter
                                                                  Comments

                                                                  For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

                                                                  Control1..1
                                                                  TypeReference(Procedimento Realizado)
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summarytrue
                                                                  Alternate NamesAdmission diagnosis, discharge diagnosis, indication
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  326. Encounter.diagnosis:procedure.condition.id
                                                                  Definition

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

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  328. Encounter.diagnosis:procedure.condition.extension
                                                                  Definition

                                                                  An Extension

                                                                  ShortExtension
                                                                  Control1..*
                                                                  TypeExtension
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  SlicingThis element introduces a set of slices on Encounter.diagnosis.condition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 330. Encounter.diagnosis:procedure.condition.extension:financier
                                                                    Slice Namefinancier
                                                                    Definition

                                                                    Agente, instituição ou entidade responsável por custear as ações e serviços de saúde.

                                                                    ShortFinanciamento
                                                                    Control1..1
                                                                    TypeExtension(Financiamento) (Extension Type: CodeableConcept)
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    332. Encounter.diagnosis:procedure.condition.reference
                                                                    Definition

                                                                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                    ShortLiteral reference, Relative, internal or absolute URL
                                                                    Comments

                                                                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                    Control1..1
                                                                    This element is affected by the following invariants: ref-1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    334. Encounter.diagnosis:procedure.condition.type
                                                                    Definition

                                                                    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                    ShortType the reference refers to (e.g. "Patient")
                                                                    Comments

                                                                    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                    Control0..1
                                                                    BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                    (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                                    Aa resource (or, for logical models, the URI of the logical model).

                                                                    Typeuri
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    336. Encounter.diagnosis:procedure.condition.identifier
                                                                    Definition

                                                                    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                    ShortLogical reference, when literal reference is not known
                                                                    Comments

                                                                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                    Control0..0
                                                                    TypeIdentifier
                                                                    Is Modifierfalse
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    338. Encounter.diagnosis:procedure.condition.display
                                                                    Definition

                                                                    Plain text narrative that identifies the resource in addition to the resource reference.

                                                                    ShortText alternative for the resource
                                                                    Comments

                                                                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                    Control0..0
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    340. Encounter.diagnosis:procedure.use
                                                                    Definition

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

                                                                    ShortRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
                                                                    Control0..0
                                                                    BindingThe codes SHOULD be taken from DiagnosisRole
                                                                    (preferred to http://hl7.org/fhir/ValueSet/diagnosis-role)

                                                                    The type of diagnosis this condition represents.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    342. Encounter.diagnosis:procedure.rank
                                                                    Definition

                                                                    Ranking of the diagnosis (for each role type).

                                                                    ShortRanking of the diagnosis (for each role type)
                                                                    Control0..0
                                                                    TypepositiveInt
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    344. Encounter.account
                                                                    Definition

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

                                                                    ShortThe set of accounts that may be used for billing for this Encounter
                                                                    Comments

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

                                                                    Control0..0
                                                                    TypeReference(Account)
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    346. Encounter.hospitalization
                                                                    Definition

                                                                    Details about the admission to a healthcare service.

                                                                    ShortDetails about the admission to a healthcare service
                                                                    Comments

                                                                    An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.

                                                                    The duration recorded in the period of this encounter covers the entire scope of this hospitalization record.

                                                                    Control1..1
                                                                    TypeBackboneElement
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    348. Encounter.hospitalization.id
                                                                    Definition

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

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    350. Encounter.hospitalization.extension
                                                                    Definition

                                                                    An Extension

                                                                    ShortExtension
                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    SlicingThis element introduces a set of slices on Encounter.hospitalization.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                    • 352. Encounter.hospitalization.extension:otherInformations
                                                                      Slice NameotherInformations
                                                                      Definition

                                                                      Representa quaisquer outras informações descritivas relacionadas aos dados de desfecho do atendimento registrado.

                                                                      ShortOutras Informações
                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeExtension(Outras Informações) (Extension Type: Annotation)
                                                                      Is Modifierfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      354. Encounter.hospitalization.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                      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.

                                                                      Control0..*
                                                                      TypeExtension
                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                      Summarytrue
                                                                      Requirements

                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                      Alternate Namesextensions, user content, modifiers
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      356. Encounter.hospitalization.preAdmissionIdentifier
                                                                      Definition

                                                                      Pre-admission identifier.

                                                                      ShortPre-admission identifier
                                                                      Control0..0
                                                                      TypeIdentifier
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      358. Encounter.hospitalization.origin
                                                                      Definition

                                                                      The location/organization from which the patient came before admission.

                                                                      ShortThe location/organization from which the patient came before admission
                                                                      Control0..0
                                                                      TypeReference(Location, Organization)
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      360. Encounter.hospitalization.admitSource
                                                                      Definition

                                                                      Identifica o serviço que encaminhou o indivíduo ou a sua iniciativa/de seu responsável na busca pelo acesso ao serviço de saúde.

                                                                      ShortProcedência
                                                                      Control1..1
                                                                      BindingThe codes SHALL be taken from Procedência do Contato Assistencial
                                                                      (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRProcedencia-1.0)

                                                                      Procedência

                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      362. Encounter.hospitalization.admitSource.id
                                                                      Definition

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

                                                                      ShortUnique id for inter-element referencing
                                                                      Control0..1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      Summaryfalse
                                                                      364. Encounter.hospitalization.admitSource.extension
                                                                      Definition

                                                                      May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                      ShortAdditional content defined by implementations
                                                                      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.

                                                                      Control0..*
                                                                      TypeExtension
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Alternate Namesextensions, user content
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      SlicingThis element introduces a set of slices on Encounter.hospitalization.admitSource.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ url
                                                                      • 366. Encounter.hospitalization.admitSource.coding
                                                                        Definition

                                                                        A reference to a code defined by a terminology system.

                                                                        ShortCode defined by a terminology system
                                                                        Comments

                                                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                        Control1..1
                                                                        TypeCoding
                                                                        Is Modifierfalse
                                                                        Summarytrue
                                                                        Requirements

                                                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        368. Encounter.hospitalization.admitSource.coding.id
                                                                        Definition

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

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Summaryfalse
                                                                        370. Encounter.hospitalization.admitSource.coding.extension
                                                                        Definition

                                                                        May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                        ShortAdditional content defined by implementations
                                                                        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.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Alternate Namesextensions, user content
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        SlicingThis element introduces a set of slices on Encounter.hospitalization.admitSource.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 372. Encounter.hospitalization.admitSource.coding.system
                                                                          Definition

                                                                          The identification of the code system that defines the meaning of the symbol in the code.

                                                                          ShortIdentity of the terminology system
                                                                          Comments

                                                                          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                                                          Control1..1
                                                                          Typeuri
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          Need to be unambiguous about the source of the definition of the symbol.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          374. Encounter.hospitalization.admitSource.coding.version
                                                                          Definition

                                                                          The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                                          ShortVersion of the system - if relevant
                                                                          Comments

                                                                          Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                                          NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                          Control0..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          376. Encounter.hospitalization.admitSource.coding.code
                                                                          Definition

                                                                          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                                          ShortSymbol in syntax defined by the system
                                                                          Control1..1
                                                                          Typecode
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          Need to refer to a particular code in the system.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          378. Encounter.hospitalization.admitSource.coding.display
                                                                          Definition

                                                                          A representation of the meaning of the code in the system, following the rules of the system.

                                                                          ShortRepresentation defined by the system
                                                                          Control0..0
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          380. Encounter.hospitalization.admitSource.coding.userSelected
                                                                          Definition

                                                                          Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                                          ShortIf this coding was chosen directly by the user
                                                                          Comments

                                                                          Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                                          Control0..0
                                                                          Typeboolean
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          382. Encounter.hospitalization.admitSource.text
                                                                          Definition

                                                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                          ShortPlain text representation of the concept
                                                                          Comments

                                                                          Very often the text is the same as a displayName of one of the codings.

                                                                          Control0..0
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          384. Encounter.hospitalization.reAdmission
                                                                          Definition

                                                                          Whether this hospitalization is a readmission and why if known.

                                                                          ShortThe type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
                                                                          Control0..0
                                                                          BindingFor example codes, see hl7VS-re-admissionIndicator
                                                                          (example to http://terminology.hl7.org/ValueSet/v2-0092)

                                                                          The reason for re-admission of this hospitalization encounter.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          386. Encounter.hospitalization.dietPreference
                                                                          Definition

                                                                          Diet preferences reported by the patient.

                                                                          ShortDiet preferences reported by the patient
                                                                          Comments

                                                                          For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).

                                                                          Control0..0
                                                                          BindingFor example codes, see Diet
                                                                          (example to http://hl7.org/fhir/ValueSet/encounter-diet)

                                                                          Medical, cultural or ethical food preferences to help with catering requirements.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          388. Encounter.hospitalization.specialCourtesy
                                                                          Definition

                                                                          Special courtesies (VIP, board member).

                                                                          ShortSpecial courtesies (VIP, board member)
                                                                          Control0..0
                                                                          BindingThe codes SHOULD be taken from SpecialCourtesy
                                                                          (preferred to http://hl7.org/fhir/ValueSet/encounter-special-courtesy)

                                                                          Special courtesies.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          390. Encounter.hospitalization.specialArrangement
                                                                          Definition

                                                                          Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.

                                                                          ShortWheelchair, translator, stretcher, etc.
                                                                          Control0..0
                                                                          BindingThe codes SHOULD be taken from SpecialArrangements
                                                                          (preferred to http://hl7.org/fhir/ValueSet/encounter-special-arrangements)

                                                                          Special arrangements.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          392. Encounter.hospitalization.destination
                                                                          Definition

                                                                          Location/organization to which the patient is discharged.

                                                                          ShortLocation/organization to which the patient is discharged
                                                                          Control0..0
                                                                          TypeReference(Location, Organization)
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          394. Encounter.hospitalization.dischargeDisposition
                                                                          Definition

                                                                          Caracteriza o motivo de conclusão total ou parcial do Contato Assistencial.

                                                                          ShortMotivo de Desfecho
                                                                          Control1..1
                                                                          BindingThe codes SHALL be taken from Motivo do desfecho do Contato assistencial
                                                                          (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRMotivoDesfecho-1.0)

                                                                          Motivo do Desfecho

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Summaryfalse
                                                                          Alternate NamesDesfecho da Internação
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          396. Encounter.hospitalization.dischargeDisposition.id
                                                                          Definition

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

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          Summaryfalse
                                                                          398. Encounter.hospitalization.dischargeDisposition.extension
                                                                          Definition

                                                                          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                          ShortAdditional content defined by implementations
                                                                          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.

                                                                          Control0..*
                                                                          TypeExtension
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Alternate Namesextensions, user content
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          SlicingThis element introduces a set of slices on Encounter.hospitalization.dischargeDisposition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 400. Encounter.hospitalization.dischargeDisposition.coding
                                                                            Definition

                                                                            A reference to a code defined by a terminology system.

                                                                            ShortCode defined by a terminology system
                                                                            Comments

                                                                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                            Control1..1
                                                                            TypeCoding
                                                                            Is Modifierfalse
                                                                            Summarytrue
                                                                            Requirements

                                                                            Allows for alternative encodings within a code system, and translations to other code systems.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            402. Encounter.hospitalization.dischargeDisposition.coding.id
                                                                            Definition

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

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Summaryfalse
                                                                            404. Encounter.hospitalization.dischargeDisposition.coding.extension
                                                                            Definition

                                                                            May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                            ShortAdditional content defined by implementations
                                                                            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.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Alternate Namesextensions, user content
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            SlicingThis element introduces a set of slices on Encounter.hospitalization.dischargeDisposition.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                            • 406. Encounter.hospitalization.dischargeDisposition.coding.system
                                                                              Definition

                                                                              The identification of the code system that defines the meaning of the symbol in the code.

                                                                              ShortIdentity of the terminology system
                                                                              Comments

                                                                              The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                                                              Control1..1
                                                                              Typeuri
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              Need to be unambiguous about the source of the definition of the symbol.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              408. Encounter.hospitalization.dischargeDisposition.coding.version
                                                                              Definition

                                                                              The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                                              ShortVersion of the system - if relevant
                                                                              Comments

                                                                              Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                                              NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              410. Encounter.hospitalization.dischargeDisposition.coding.code
                                                                              Definition

                                                                              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                                              ShortSymbol in syntax defined by the system
                                                                              Control1..1
                                                                              Typecode
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              Need to refer to a particular code in the system.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              412. Encounter.hospitalization.dischargeDisposition.coding.display
                                                                              Definition

                                                                              A representation of the meaning of the code in the system, following the rules of the system.

                                                                              ShortRepresentation defined by the system
                                                                              Control0..0
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              414. Encounter.hospitalization.dischargeDisposition.coding.userSelected
                                                                              Definition

                                                                              Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                                              ShortIf this coding was chosen directly by the user
                                                                              Comments

                                                                              Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                                              Control0..0
                                                                              Typeboolean
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              416. Encounter.hospitalization.dischargeDisposition.text
                                                                              Definition

                                                                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                              ShortPlain text representation of the concept
                                                                              Comments

                                                                              Very often the text is the same as a displayName of one of the codings.

                                                                              Control0..0
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              418. Encounter.location
                                                                              Definition

                                                                              Local onde o atendimento aconteceu.

                                                                              ShortLocal de Atendimento
                                                                              Comments

                                                                              Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".

                                                                              Control0..1
                                                                              TypeBackboneElement
                                                                              Is Modifierfalse
                                                                              Must Supporttrue
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              420. Encounter.location.id
                                                                              Definition

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

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Summaryfalse
                                                                              422. Encounter.location.extension
                                                                              Definition

                                                                              May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                              ShortAdditional content defined by implementations
                                                                              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.

                                                                              Control0..*
                                                                              TypeExtension
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Alternate Namesextensions, user content
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              424. Encounter.location.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                              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.

                                                                              Control0..*
                                                                              TypeExtension
                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                              Summarytrue
                                                                              Requirements

                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                              Alternate Namesextensions, user content, modifiers
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              426. Encounter.location.location
                                                                              Definition

                                                                              The location where the encounter takes place.

                                                                              ShortLocation the encounter takes place
                                                                              Control1..1
                                                                              TypeReference(Local de Atendimento)
                                                                              Is Modifierfalse
                                                                              Must Supporttrue
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              428. Encounter.location.location.id
                                                                              Definition

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

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Summaryfalse
                                                                              430. Encounter.location.location.extension
                                                                              Definition

                                                                              May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                              ShortAdditional content defined by implementations
                                                                              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.

                                                                              Control0..*
                                                                              TypeExtension
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Alternate Namesextensions, user content
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              SlicingThis element introduces a set of slices on Encounter.location.location.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 432. Encounter.location.location.reference
                                                                                Definition

                                                                                A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                ShortLiteral reference, Relative, internal or absolute URL
                                                                                Comments

                                                                                Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                Control1..1
                                                                                This element is affected by the following invariants: ref-1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                434. Encounter.location.location.type
                                                                                Definition

                                                                                The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                                The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                                ShortType the reference refers to (e.g. "Patient")
                                                                                Comments

                                                                                This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                                Control0..0
                                                                                BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                                (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                                                Aa resource (or, for logical models, the URI of the logical model).

                                                                                Typeuri
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                436. Encounter.location.location.identifier
                                                                                Definition

                                                                                An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                ShortLogical reference, when literal reference is not known
                                                                                Comments

                                                                                When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                Control0..0
                                                                                TypeIdentifier
                                                                                Is Modifierfalse
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                438. Encounter.location.location.display
                                                                                Definition

                                                                                Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                ShortText alternative for the resource
                                                                                Comments

                                                                                This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                Control0..0
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                440. Encounter.location.status
                                                                                Definition

                                                                                The status of the participants' presence at the specified location during the period specified. If the participant is no longer at the location, then the period will have an end date/time.

                                                                                Shortplanned | active | reserved | completed
                                                                                Comments

                                                                                When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed.

                                                                                Control0..0
                                                                                BindingThe codes SHALL be taken from EncounterLocationStatus
                                                                                (required to http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1)

                                                                                The status of the location.

                                                                                Typecode
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                442. Encounter.location.physicalType
                                                                                Definition

                                                                                This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query.

                                                                                ShortThe physical type of the location (usually the level in the location hierachy - bed room ward etc.)
                                                                                Comments

                                                                                This information is de-normalized from the Location resource to support the easier understanding of the encounter resource and processing in messaging or query.

                                                                                There may be many levels in the hierachy, and this may only pic specific levels that are required for a specific usage scenario.

                                                                                Control0..0
                                                                                BindingFor example codes, see LocationType
                                                                                (example to http://hl7.org/fhir/ValueSet/location-physical-type)

                                                                                Physical form of the location.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                444. Encounter.location.period
                                                                                Definition

                                                                                Time period during which the patient was present at the location.

                                                                                ShortTime period during which the patient was present at the location
                                                                                Control0..0
                                                                                TypePeriod
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                446. Encounter.serviceProvider
                                                                                Definition

                                                                                Identifica pelo número de inscrição no Cadastro Nacional de Estabelecimentos de Saúde o Estabelecimento de Saúde que realizou o Contato Assistencial.

                                                                                ShortEstabelecimento de Saúde do Contato Assistencial
                                                                                Control1..1
                                                                                TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BREstabelecimentoSaude-1.0, http://www.saude.gov.br/fhir/r4/StructureDefinition/BRPessoaJuridicaProfissionalLiberal-1.0)
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                448. Encounter.serviceProvider.id
                                                                                Definition

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

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                450. Encounter.serviceProvider.extension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                ShortAdditional content defined by implementations
                                                                                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.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                SlicingThis element introduces a set of slices on Encounter.serviceProvider.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 452. Encounter.serviceProvider.reference
                                                                                  Definition

                                                                                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                  ShortLiteral reference, Relative, internal or absolute URL
                                                                                  Comments

                                                                                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                  Control0..0
                                                                                  This element is affected by the following invariants: ref-1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  454. Encounter.serviceProvider.type
                                                                                  Definition

                                                                                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                                  ShortType the reference refers to (e.g. "Patient")
                                                                                  Comments

                                                                                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                                  Control0..0
                                                                                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                                                  Aa resource (or, for logical models, the URI of the logical model).

                                                                                  Typeuri
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  456. Encounter.serviceProvider.identifier
                                                                                  Definition

                                                                                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                  ShortLogical reference, when literal reference is not known
                                                                                  Comments

                                                                                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                  Control1..1
                                                                                  TypeIdentifier
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  458. Encounter.serviceProvider.identifier.id
                                                                                  Definition

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

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Summaryfalse
                                                                                  460. Encounter.serviceProvider.identifier.extension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                  ShortAdditional content defined by implementations
                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  SlicingThis element introduces a set of slices on Encounter.serviceProvider.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 462. Encounter.serviceProvider.identifier.use
                                                                                    Definition

                                                                                    The purpose of this identifier.

                                                                                    Shortusual | official | temp | secondary | old (If known)
                                                                                    Comments

                                                                                    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                                                                    Control0..0
                                                                                    BindingThe codes SHALL be taken from IdentifierUse
                                                                                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                                                                    Identifies the purpose for this identifier, if known .

                                                                                    Typecode
                                                                                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    464. Encounter.serviceProvider.identifier.type
                                                                                    Definition

                                                                                    A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                                                                    ShortDescription of identifier
                                                                                    Comments

                                                                                    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                                                                    Control0..0
                                                                                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                                                                                    A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                                                                    TypeCodeableConcept
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Allows users to make use of identifiers when the identifier system is not known.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    466. Encounter.serviceProvider.identifier.system
                                                                                    Definition

                                                                                    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                                                                    ShortThe namespace for the identifier value
                                                                                    Comments

                                                                                    Identifier.system is always case sensitive.

                                                                                    Control1..1
                                                                                    Typeuri
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                                                                    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    468. Encounter.serviceProvider.identifier.value
                                                                                    Definition

                                                                                    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                                                                    ShortThe value that is unique
                                                                                    Comments

                                                                                    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                                                                    Control1..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Example<br/><b>General</b>:123456
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    470. Encounter.serviceProvider.identifier.period
                                                                                    Definition

                                                                                    Time period during which identifier is/was valid for use.

                                                                                    ShortTime period when id is/was valid for use
                                                                                    Control0..0
                                                                                    TypePeriod
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    472. Encounter.serviceProvider.identifier.assigner
                                                                                    Definition

                                                                                    Organization that issued/manages the identifier.

                                                                                    ShortOrganization that issued id (may be just text)
                                                                                    Comments

                                                                                    The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                                                                    Control0..0
                                                                                    TypeReference(Organization)
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    474. Encounter.serviceProvider.display
                                                                                    Definition

                                                                                    Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                    ShortText alternative for the resource
                                                                                    Comments

                                                                                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                    Control0..0
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    476. Encounter.partOf
                                                                                    Definition

                                                                                    Permite referenciar outro Contato Assistencial que tenha dado sequência a este, como por exemplo, um indivíduo realiza, em um mesmo Estabelecimento de Saúde, um Contato Assistencial que seja de Modalidade Assistencial Atenção à Urgência/Emergência, e necessite ser internado, dando continuidade em um Contato Assistencial de Atenção Hospitalar. Neste exemplo, este elemento seria utilizado no Contato Assistencial de Atenção Hospitalar, que faria referência ao Contato Assistencial de Atenção à Urgência/Emergência.

                                                                                    ShortContato Assistencial anterior
                                                                                    Comments

                                                                                    This is also used for associating a child's encounter back to the mother's encounter.

                                                                                    Refer to the Notes section in the Patient resource for further details.

                                                                                    Control0..1
                                                                                    TypeReference(Contato Assistencial)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    478. Encounter.partOf.id
                                                                                    Definition

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

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Summaryfalse
                                                                                    480. Encounter.partOf.extension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                    ShortAdditional content defined by implementations
                                                                                    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.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Alternate Namesextensions, user content
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    SlicingThis element introduces a set of slices on Encounter.partOf.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • value @ url
                                                                                    • 482. Encounter.partOf.reference
                                                                                      Definition

                                                                                      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                      ShortLiteral reference, Relative, internal or absolute URL
                                                                                      Comments

                                                                                      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                      Control1..1
                                                                                      This element is affected by the following invariants: ref-1
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summarytrue
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      484. Encounter.partOf.type
                                                                                      Definition

                                                                                      The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                                      The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                                      ShortType the reference refers to (e.g. "Patient")
                                                                                      Comments

                                                                                      This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                                      Control0..0
                                                                                      BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                                      (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                                                      Aa resource (or, for logical models, the URI of the logical model).

                                                                                      Typeuri
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summarytrue
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      486. Encounter.partOf.identifier
                                                                                      Definition

                                                                                      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                      ShortLogical reference, when literal reference is not known
                                                                                      Comments

                                                                                      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                      Control0..0
                                                                                      TypeIdentifier
                                                                                      Is Modifierfalse
                                                                                      Summarytrue
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      488. Encounter.partOf.display
                                                                                      Definition

                                                                                      Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                      ShortText alternative for the resource
                                                                                      Comments

                                                                                      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                      Control0..0
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summarytrue
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))