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EpisodeOfCare

Overview​

The EpisodeOfCare resource provides information about an association between a patient and an organization/healthcare provider(s) during which time encounters may occur. The managing organization assumes a level of responsibility for the patient during this time. (HL7 FHIR R4 EpisodeOfCare)

Use Cases​

  • Managing patient care across multiple encounters
  • Tracking care episodes for specific conditions or treatments
  • Coordinating care between different healthcare providers
  • Supporting care continuity and episode-based billing

Relationships​

  • Patient/Group: The patient or group who is the focus of this episode of care
  • Organization: The organization that assumes responsibility for care coordination
  • Condition: Medical conditions being addressed during the episode
  • Encounter: Individual encounters that occur within the episode
  • CareTeam: Healthcare providers involved in the episode
  • ServiceRequest: Originating referral requests

Resource Schema​

Key Fields​

FieldTypeDescriptionRequired
idstringLogical id of the resourceNo
identifierIdentifier[]Business identifier(s) for this episode of careNo
statuscodeplanned | waitlist | active | onhold | finished | cancelled | entered-in-errorYes
statusHistoryBackboneElement[]Past list of status codesNo
typeCodeableConcept[]Type/class - e.g. specialist referral, disease managementNo
reasonBackboneElement[]The list of medical reasons that are expected to be addressed during the episode of careNo
diagnosisBackboneElement[]The list of medical conditions that were addressed during the episode of careNo
subjectReference(Patient|Group)The patient/group who is the focus of this episode of careYes
managingOrganizationReference(Organization)Organization that assumes careNo
periodPeriodInterval during responsibility is assumedNo
referralRequestReference(ServiceRequest)[]Originating Referral Request(s)No
careManagerReference(Practitioner|PractitionerRole)Care manager/care coordinator for the patientNo
careTeamReference(CareTeam)[]Other practitioners facilitating this episode of careNo
accountReference(Account)[]The set of accounts that may be used for billing for this EpisodeOfCareNo

JSON Example​

{
  "resourceType": "EpisodeOfCare",
  "id": "example",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n      HACC Program for Peter James Chalmers at HL7 Healthcare 15 Sept 2014 - current<br/>\n\t\t\twas on leave from 22 Sept - 24 Sept while in respite care\n    </div>"
  },
  "identifier": [{
    "system": "http://example.org/sampleepisodeofcare-identifier",
    "value": "123"
  }],
  "status": "active",
  "statusHistory": [{
    "status": "planned",
    "period": {
      "start": "2014-09-01",
      "end": "2014-09-14"
    }
  },
  {
    "status": "active",
    "period": {
      "start": "2014-09-15",
      "end": "2014-09-21"
    }
  },
  {
    "status": "onhold",
    "period": {
      "start": "2014-09-22",
      "end": "2014-09-24"
    }
  },
  {
    "status": "active",
    "period": {
      "start": "2014-09-25"
    }
  }],
  "type": [{
    "coding": [{
      "system": "http://terminology.hl7.org/CodeSystem/episodeofcare-type",
      "code": "hacc",
      "display": "Home and Community Care"
    }]
  }],
  "diagnosis": [{
    "condition": [{
      "reference": {
        "reference": "Condition/stroke"
      }
    }],
    "use": [{
      "coding": [{
        "system": "http://terminology.hl7.org/CodeSystem/diagnosis-role",
        "code": "CC",
        "display": "Chief complaint"
      }]
    }]
  }],
  "subject": {
    "reference": "Patient/example"
  },
  "managingOrganization": {
    "reference": "Organization/hl7"
  },
  "period": {
    "start": "2014-09-01"
  },
  "referralRequest": [{
    "display": "Referral from Example Aged Care Services"
  }],
  "careManager": {
    "reference": "Practitioner/f204",
    "display": "Carla Espinosa"
  },
  "careTeam": [{
    "reference": "CareTeam/example",
    "display": "example care team"
  }],
  "account": [{
    "reference": "Account/example",
    "display": "example account"
  }]
}

Operations​

The Certified API EpisodeOfCare resource supports the following standard operations. However, support varies by the targeted CareRecord or solution.

CareRecord / SolutionCreateReadUpdateSearch
GEHRIMED-Yes-Yes
myAvatar-Yes-Yes
myEvolv-Yes-Yes
myUnity-Yes-Yes
TheraOffice-Yes-Yes

Read​

Retrieve a specific EpisodeOfCare resource by its ID.

Syntax: GET [base]/EpisodeOfCare/[id]

Search for episodes of care using various criteria.

GET Method​

Use GET for simple searches with parameters in the query string.

GET /EpisodeOfCare?parameter=value

POST Method​

Use POST for complex searches with form-encoded parameters.

POST /EpisodeOfCare/_search
info

Not all Netsmart solutions support EpisodeOfCare search. See supported operations table above and consult your target solution's documentation for more information.

Search Parameters​

Patient-based Search:

ParameterTypeRequiredDescriptionExample
patientreferenceYesThe patient who is the focus of this episode of carepatient=value
datedateNoThe provided date search value falls within the episode of care's perioddate=value
identifierreferenceNoBusiness Identifier(s) relevant for this EpisodeOfCareidentifier=value
incoming-referralreferenceNoIncoming Referral Requestincoming-referral=value
organizationreferenceNoThe organization that has assumed the specific responsibilities of this EpisodeOfCareorganization=value
statustokenNoThe current status of the Episode of Care as provided (does not check the status history collection)status=value
typetokenNoType/class - e.g. specialist referral, disease managementtype=value

| _lastUpdated | date | No | Only return resources which were last updated as specified by the given range | _lastUpdated=value | | _revinclude | special | No | Include Provenance resource(s) that reference the matched search results. Allowed: "Provenance:target" | _revinclude=value |

ID-based Search:

ParameterTypeRequiredDescriptionExample
_idstringYesThe ID of the resource_id=value
_lastUpdateddateNoOnly return resources which were last updated as specified by the given range_lastUpdated=value
_revincludespecialNoInclude Provenance resource(s) that reference the matched search results. Allowed: "Provenance:target"_revinclude=value

Examples​

Read EpisodeOfCare​

Read EpisodeOfCare by ID
curl -X GET https://fhir.netsmartcloud.com/provider/system-access/v2/{tenant-id}/EpisodeOfCare/123 \
    -H "Authorization: {Bearer Token}" \
    -H "Accept: application/fhir+json"

Search EpisodeOfCare​

Search by Patient (POST)​

The POST method is recommended as it keeps health information out of the URL.

Search by Patient
curl -X POST https://fhir.netsmartcloud.com/provider/system-access/v2/{tenant-id}/EpisodeOfCare/_search \
    -H "Authorization: {Bearer Token}" \
    -H "Accept: application/fhir+json" \
    -H "Content-Type: application/x-www-form-urlencoded" \
    -d "patient=Patient/123"

Search by Patient and Status (POST)​

Search by Patient and Status
curl -X POST https://fhir.netsmartcloud.com/provider/system-access/v2/{tenant-id}/EpisodeOfCare/_search \
    -H "Authorization: {Bearer Token}" \
    -H "Accept: application/fhir+json" \
    -H "Content-Type: application/x-www-form-urlencoded" \
    -d "patient=Patient/123" \
    -d "status=active"

Search by Patient (GET)​

Search by Patient
curl -X GET https://fhir.netsmartcloud.com/provider/system-access/v2/{tenant-id}/EpisodeOfCare?patient=Patient/123 \
    -H "Authorization: {Bearer Token}" \
    -H "Accept: application/fhir+json"