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Merge pull request #164 from hl7dk/150-profiling-of-encounter
150 profiling of encounter
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‎input/fsh/DkCoreEncounter.fsh‎

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Profile: DkCoreEncounter
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Parent: Encounter
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Id: dk-core-encounter
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Title: "Danish Core Encounter Profile"
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Description: "HL7 Denmark core profile for an encounter"
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* extension contains
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PlannedStartDate named plannedStartDate 0..1 and
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PlannedEndDate named plannedEndDate 0..1 and
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CareProvider named careProvider 0..1
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* extension[plannedStartDate] ^short = "The planned start date/time (or admission date) of the encounter"
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* extension[plannedEndDate] ^short = "The planned end date/time (or discharge date) of the encounter"
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* extension[careProvider] ^short = "The organization (facility) responsible for the care of the patient during this encounter"
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* priority from DkCoreEncounterPriority (extensible)
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* subject only Reference(DkCorePatient)
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* diagnosis ^slicing.discriminator.type = #type
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* diagnosis ^slicing.discriminator.path = condition
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* diagnosis ^slicing.rules = #open
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* diagnosis ^slicing.description = "Slicing based on condition type"
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* diagnosis contains dk-core-conditions 0..*
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* diagnosis[dk-core-conditions].condition only Reference(DkCoreCondition)
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* diagnosis[dk-core-conditions].rank 1..1
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* serviceProvider only Reference(DkCoreOrganization)

‎input/fsh/aliases.fsh‎

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Alias: $LOINC-vitalsigns = http://hl7.org/fhir/ValueSet/observation-vitalsignresult
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Alias: $v3-Confidentiality = http://terminology.hl7.org/CodeSystem/v3-Confidentiality
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Alias: $v3-RoleCode = http://terminology.hl7.org/CodeSystem/v3-RoleCode
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Alias: $v3-ActPriority = http://terminology.hl7.org/CodeSystem/v3-ActPriority

‎input/fsh/codeSystems.fsh‎

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* ^property[+].code = #status
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* ^property[=].valueCode = #active
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* ^property[+].code = #comment
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* ^property[=].valueString = "Unit defined"
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* ^property[=].valueString = "Unit defined"

‎input/fsh/extensions.fsh‎

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* . ^short = "Danish Core Municipality codes"
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* ^definition = "Identifier holding the official identifier for a danish municipality"
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* value[x] only CodeableConcept
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* coding from MunicipalityCodes (required)
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* coding from MunicipalityCodes (required)
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Extension: PlannedStartDate
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Id: dk-core-planned-start-date
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Title: "PlannedStartDate"
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* . ^short = "PlannedStartDate"
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* ^definition = "The planned start date/time (or admission date) of the encounter"
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* value[x] only dateTime
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* ^context.type = http://hl7.org/fhir/extension-context-type#element
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* ^context.expression = "Encounter"
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Extension: PlannedEndDate
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Id: dk-core-planned-end-date
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Title: "PlannedEndDate"
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* . ^short = "PlannedEndDate"
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* ^definition = "The planned end date/time (or discharge date) of the encounter"
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* value[x] only dateTime
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* ^context.type = http://hl7.org/fhir/extension-context-type#element
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* ^context.expression = "Encounter"
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Extension: CareProvider
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Id: dk-core-care-provider
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Title: "CareProvider"
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* . ^short = "CareProvider"
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* ^definition = "The organization (facility) reponsible for the care of the patient during this encounter"
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* value[x] only Reference(DkCoreOrganization)
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* ^context.type = http://hl7.org/fhir/extension-context-type#element
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* ^context.expression = "Encounter"

‎input/fsh/valueSets.fsh‎

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* $sct#255203001
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* $sct#264372000
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ValueSet: DkCoreEncounterPriority
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Id: dk-core-encounter-priority
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Title: "DK priority codes for encounters"
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Description: "Value set used for indicating priority of an encounter"
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* ^experimental = false
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* ^status = #active
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* $v3-ActPriority#A
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* $v3-ActPriority#EL
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ValueSet: SorPracticeSettingCode
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Id: dk-core-practice-setting-code

‎input/pagecontent/StructureDefinition-dk-core-encounter-intro.md‎

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### Scope and usage
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This profile is intended to encapsulate information about encounters in the Danish health sectors.
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### Responsibilities for treatment and care
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In Denmark there is a distinguishment between which organization has the reponsibility for providing treatment to the patient, and which organization
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has the responsibility for providing care to the patient.
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* Treatment responsibility ([DA] behandlingsansvarlig): this lies with the service provider organization
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* Care responsibility ([DA] plejeansvarlig): this lies with the organization where the patient has a stay (is hospitalized)
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The treatment responsibility is represented by Encounter.serviceProvider and the current care responsibility is represented by the
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extension [CareProvider](./StructureDefinition-dk-core-care-provider.html).
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## Specifying primary and secondary diagnosis
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Hospital encounters in Denmark have diagnosis associated that specifies the primary diagnosis beeing treated ([DA] aktionsdiagnose) and secondary diagnosis ([DA] bidiagnose) that might be relevant to the treatment of the primary diagnosis. These can be given in the diagnosis element and it is recommended to use the rank element to distinguish between primary and secondary diagnoses, the primary being given rank 1 and the secondary a rank > 1.
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### Handling future versions
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In FHIR R5 and newer, there have been made significant changes to Encounter profile.
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In order to be compatible with the changes to the value set bound to Encounter.class in FHIR R5 and newer, we recommend to restrict to using only
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the values from the FHIR R5 value set [Encounter class](https://terminology.hl7.org/5.2.0/ValueSet-encounter-class.html), which is a subset of the
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FHIR R4 value set [ActEncounterCode](https://hl7.org/fhir/R4/v3/ActEncounterCode/vs.html):
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{:class="grid"}
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| Code | Display | Typical use in Denmark |
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| ---- | ------- | -------------- |
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| IMP | inpatient encounter | Encounters where patients are admitted typically for more than 12 hours. |
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| AMB | ambulatory | Encounters where patients are not admitted. |
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| OBSENC | observation encounter | Not used. |
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| EMER | emergency | Encounters where patients are admitted to an emergency ward typically for up to 72 hours. |
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| VR | virtual | Virtual encounters with patients typically using televideo, telephone, or other means of telepresence. |
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| HH | home health | Encounters with patients in their own home. |
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Note that Encounter.class has an extensible binding, so if a class coding not part of the bound value set is needed, it is allowed to use an
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alternate coding.
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In order to support the addition of Encounter.plannedStartDate and Encounter.plannedEndDate in FHIR R5, the extensions
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[PlannedStartDate](./StructureDefinition-dk-core-planned-start-date.html) and [PlannedEndDate](./StructureDefinition-dk-core-planned-end-date.html)
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have been added to DkCore. However, note that in the R4 documentation it is stated that a planned start date could be given by placing
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period.start in the future, and setting the status to ‘planned’. As a consequence, this practice is also acceptable in the dk-core R4 version,
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but the use of plannedStart and plannedEnd extensions are encouraged to make transition to future FHIR versions easier.

‎input/pagecontent/index.md‎

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Pull requests are even better. If you are in a position to suggest how exactly your proposal should be implemented in the specification, do it! It helps the team maintaining the implementation guide a great deal.
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### Language
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The main language of this implementation guide, and the profiles in it, is English. Content that does not have an official English term uses a Danish term instead. Sometimes terms are explained using both Danish and English. Danish terms and explanations are prefixed with 'Da'
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The main language of this implementation guide, and the profiles in it, is English. Content that does not have an official English term uses a Danish term instead. Sometimes terms are explained using both Danish and English. Danish terms and explanations are prefixed with [DA]
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### Connection between dk-core and common Danish architectures and standards
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HL7 Denmark includes common Danish architectures and standards if relevant, when content is added to dk-core. This section provides information about principle decisions as well as more specific ones that require explanations.

‎sushi-config.yaml‎

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#Flip status to 'active' for publication. Flip to 'draft' for CI
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status: draft
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#status: active
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#Flip releaseLabel to 'release' for publication. Flip to 'ci-build' for CI
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releaseLabel: ci-build
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#releaseLabel: release
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#releaseLabel: release

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