---
type: "resource-definitions"
title: "EpisodeOfCare Definitions"
resource: "EpisodeOfCare"
---

# EpisodeOfCare Definitions

<a id="EpisodeOfCare"></a>

## EpisodeOfCare
An association of a Patient with an Organization and  Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility

**Definition:** 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.

**Aliases:** Case Program Problem

**Cardinality:** 0..*

**Mappings:** workflow=Event; rim=n/a; w5=workflow.encounter


<a id="EpisodeOfCare.identifier"></a>

## EpisodeOfCare.identifier
Business Identifier(s) relevant for this EpisodeOfCare

**Definition:** The EpisodeOfCare may be known by different identifiers for different contexts of use, such as when an external agency is tracking the Episode for funding purposes.

**Cardinality:** 0..*

**Type:** [Identifier](/Identifier)

**Mappings:** workflow=Event.identifier; w5=FiveWs.identifier


<a id="EpisodeOfCare.status"></a>

## EpisodeOfCare.status
planned | waitlist | active | onhold | finished | cancelled | entered-in-error

**Definition:** planned | waitlist | active | onhold | finished | cancelled.

**Comments:** This element is labeled as a modifier because the status contains codes that mark the episode as not currently valid.

**Cardinality:** 1..1

**Type:** [code](/code)

**Binding:** required:[episode-of-care-status](/valueset-episode-of-care-status)

**Summary:** true

**Is Modifier:** true (Reason: This element is labelled 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)

**Mappings:** workflow=Event.status; w5=FiveWs.status


<a id="EpisodeOfCare.statusHistory"></a>

## EpisodeOfCare.statusHistory
Past list of status codes (the current status may be included to cover the start date of the status)

**Definition:** The history of statuses that the EpisodeOfCare has been through (without requiring processing the history of the resource).

**Cardinality:** 0..*

**Type:** [BackboneElement](/BackboneElement)


<a id="EpisodeOfCare.statusHistory.status"></a>

## EpisodeOfCare.statusHistory.status
planned | waitlist | active | onhold | finished | cancelled | entered-in-error

**Definition:** planned | waitlist | active | onhold | finished | cancelled.

**Cardinality:** 1..1

**Type:** [code](/code)

**Binding:** required:[episode-of-care-status](/valueset-episode-of-care-status)


<a id="EpisodeOfCare.statusHistory.period"></a>

## EpisodeOfCare.statusHistory.period
Duration the EpisodeOfCare was in the specified status

**Definition:** The period during this EpisodeOfCare that the specific status applied.

**Cardinality:** 1..1

**Type:** [Period](/Period)


<a id="EpisodeOfCare.type"></a>

## EpisodeOfCare.type
Type/class  - e.g. specialist referral, disease management

**Definition:** A classification of the type of episode of care; e.g. specialist referral, disease management, type of funded care.

**Comments:** The type can be very important in processing as this could be used in determining if the EpisodeOfCare is relevant to specific government reporting, or other types of classifications.

**Cardinality:** 0..*

**Type:** [CodeableConcept](/CodeableConcept)

**Binding:** example:[episodeofcare-type](/valueset-episodeofcare-type)

**Summary:** true

**Mappings:** workflow=Event.code; w5=FiveWs.class


<a id="EpisodeOfCare.reason"></a>

## EpisodeOfCare.reason
The list of medical reasons that are expected to be addressed during the episode of care

**Definition:** The list of medical reasons that are expected to be addressed during the episode of care.

**Comments:** The reason communicates what medical problem the patient has that should be addressed during the episode of care.  This reason could be patient reported complaint, a clinical indication that was determined in a previous encounter or episode of care, or some planned care such as an immunization recommendation.  In the case where you have a primary reason, but are expecting to also address other problems, you can list the primary reason with a use code of 'Chief Complaint', while the other problems being addressed would have a use code of 'Reason for Visit'.

Examples:
 * pregnancy would use HealthcareService or a coding as the reason
 * patient home monitoring could use Condition as the reason

**Cardinality:** 0..*

**Type:** [BackboneElement](/BackboneElement)

**Summary:** true


<a id="EpisodeOfCare.reason.use"></a>

## EpisodeOfCare.reason.use
What the reason value should be used for/as

**Definition:** What the reason value should be used as e.g. Chief Complaint, Health Concern, Health Maintenance (including screening).

**Cardinality:** 0..*

**Type:** [CodeableConcept](/CodeableConcept)

**Binding:** example:[encounter-reason-use](/valueset-encounter-reason-use)

**Summary:** true


<a id="EpisodeOfCare.reason.value"></a>

## EpisodeOfCare.reason.value
Medical reason to be addressed

**Definition:** The medical reason that is expected to be addressed during the episode of care, expressed as a text, code or a reference to another resource.

**Cardinality:** 0..*

**Type:** [CodeableReference](/CodeableReference)

**Binding:** example:[encounter-reason](/valueset-encounter-reason)

**Summary:** true

**Mappings:** workflow=Event.reason; w5=FiveWs.what[x]


<a id="EpisodeOfCare.diagnosis"></a>

## EpisodeOfCare.diagnosis
The list of medical conditions that were addressed during the episode of care

**Definition:** The list of medical conditions that were addressed during the episode of care.

**Comments:** The diagnosis communicates what medical conditions were actually addressed during the episode of care.  If a diagnosis was provided as a reason, and was treated during the episode of care, it may be listed in both EpisodeOfCare.reason and EpisodeOfCare.diagnosis.

Diagnoses related to billing can be documented on the Account resources which supports ranking for the purpose of reimbursement.

**Cardinality:** 0..*

**Type:** [BackboneElement](/BackboneElement)

**Summary:** true


<a id="EpisodeOfCare.diagnosis.condition"></a>

## EpisodeOfCare.diagnosis.condition
The medical condition that was addressed during the episode of care

**Definition:** The medical condition that was addressed during the episode of care, expressed as a text, code or a reference to another resource.

**Cardinality:** 0..*

**Type:** [CodeableReference](/CodeableReference)

**Binding:** example:[condition-code](/valueset-condition-code)

**Summary:** true

**Mappings:** workflow=Event.reason; w5=FiveWs.what[x]


<a id="EpisodeOfCare.diagnosis.use"></a>

## EpisodeOfCare.diagnosis.use
Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …)

**Definition:** Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …).

**Cardinality:** 0..*

**Type:** [CodeableConcept](/CodeableConcept)

**Binding:** preferred:[encounter-diagnosis-use](/valueset-encounter-diagnosis-use)

**Summary:** true


<a id="EpisodeOfCare.subject"></a>

## EpisodeOfCare.subject
The patient/group who is the focus of this episode of care

**Definition:** The patient/group who is the focus of this episode of care.

**Cardinality:** 1..1

**Type:** Reference([Patient](/Patient), [Group](/Group))

**Summary:** true

**Mappings:** workflow=Event.subject; w5=FiveWs.subject


<a id="EpisodeOfCare.managingOrganization"></a>

## EpisodeOfCare.managingOrganization
Organization that assumes responsibility for care coordination

**Definition:** The organization that has assumed the specific responsibilities for care coordination, care delivery, or other services for the specified duration.

**Comments:** If multiple organizations are involved in care delivery, the care teams from those organizations would be represented in EpisodeOfCare.team, while the primary organization managing the care would be listed in EpisodeOfCare.managingOrganization.   Other organizations may have their own EpisodeOfCare for tracking their activities.

**Cardinality:** 0..1

**Type:** Reference([Organization](/Organization))

**Summary:** true

**Mappings:** workflow=Event.performer.actor


<a id="EpisodeOfCare.period"></a>

## EpisodeOfCare.period
Interval during responsibility is assumed

**Definition:** The interval during which the managing organization assumes the defined responsibility.

**Cardinality:** 0..1

**Type:** [Period](/Period)

**Summary:** true

**Mappings:** workflow=Event.occurrence[x]; w5=FiveWs.init


<a id="EpisodeOfCare.referralRequest"></a>

## EpisodeOfCare.referralRequest
Originating Referral Request(s)

**Definition:** Referral Request(s) that are fulfilled by this EpisodeOfCare, incoming referrals.

**Cardinality:** 0..*

**Type:** Reference([ServiceRequest](/ServiceRequest))

**Mappings:** workflow=Event.basedOn


<a id="EpisodeOfCare.careManager"></a>

## EpisodeOfCare.careManager
Care manager/care coordinator for the patient

**Definition:** The practitioner that is the care manager/care coordinator for this patient.

**Cardinality:** 0..1

**Type:** Reference([Practitioner](/Practitioner), [PractitionerRole](/PractitionerRole))

**Mappings:** workflow=Event.performer.actor


<a id="EpisodeOfCare.careTeam"></a>

## EpisodeOfCare.careTeam
Other practitioners facilitating this episode of care

**Definition:** The list of practitioners that may be facilitating this episode of care for specific purposes.

**Comments:** Multiple care teams may represent different teams that provide care at different times, where those time periods would be distinguished in CareTeam.period.  Also, a single episode may have different types of care teams, which would be distinguished in CareTeam.category.

**Aliases:** CareTeam

**Cardinality:** 0..*

**Type:** Reference([CareTeam](/CareTeam))

**Mappings:** workflow=Event.performer.actor


<a id="EpisodeOfCare.account"></a>

## EpisodeOfCare.account
The set of accounts that may be used for billing for this EpisodeOfCare

**Definition:** The set of accounts that may be used for billing for this EpisodeOfCare.

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

Also note that the EpisodeOfCare.account properties are meant to represent long-running or perpetual accounts.  For short-lived, episodic accounts, see Account.covers.

**Cardinality:** 0..*

**Type:** Reference([Account](/Account))