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I'm currently working on an administrative information system for primary care, using the FHIR specification as reference in some use cases.

For community care, I didn't find any corresponding resources. Anyone have any idea how I can implement community care "encounters"? The encounter resource in FHIR doesn't allow multiple patients. Same for Appointment. While this resource allow the use of multiple patients, it doesn't have a direct reference for a group of patients (e.g. Community or Family). Would it make sense to use another Actor type in the Participant element, rather than "A person or Device"?

Ricardo Vasconcelos
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As always, it depends on what the purpose of the encounter is. You could create an encounter for each participant in the group session and then make them all a part-of a parent encounter that joins them together that doesn't have a patient specified. This would then ensure that each patients history is still correct and representative of what has occurred. Also if govt reporting is required you still have the granularity needed, maybe you'd need an extension to indicate reporting status, group claiming vs per client claiming.

Will pass this onto the patient admin group for some discussion.

Brian

Brian Postlethwaite
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  • After some discussion in the PA workgroup conference call, we discovered that the cardinality of the subject should be 1..1, not optional, so a parent "part-of" encounter without subject would not be possible. Instead you would have to use extension to include a reference to a group resource, or if you have a common identifier, you could use that on each of the individual encounter instances. If you have a case for including Group as the subject of the encounter, we would love to hear from you with your requirements. – Brian Postlethwaite Nov 10 '14 at 22:11
  • Looking further at the Appointment section of your question... Each of the participants could be creating their own appointment to attend the group session. Your system could mark the slot as busy only after "n" appointments have been created to fill it. A HealthcareService resource would be the actor on the Slot/Availability Schedule which describes the Group Service e.g. "South Melbourne Monday HydroTherapy" – Brian Postlethwaite Nov 10 '14 at 22:17