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

Field	Type	Description	Required
id	string	Logical id of the resource	No
identifier	Identifier[]	Business identifier(s) for this episode of care	No
status	code	planned \| waitlist \| active \| onhold \| finished \| cancelled \| entered-in-error	Yes
statusHistory	BackboneElement[]	Past list of status codes	No
type	CodeableConcept[]	Type/class - e.g. specialist referral, disease management	No
reason	BackboneElement[]	The list of medical reasons that are expected to be addressed during the episode of care	No
diagnosis	BackboneElement[]	The list of medical conditions that were addressed during the episode of care	No
subject	Reference(Patient\|Group)	The patient/group who is the focus of this episode of care	Yes
managingOrganization	Reference(Organization)	Organization that assumes care	No
period	Period	Interval during responsibility is assumed	No
referralRequest	Reference(ServiceRequest)[]	Originating Referral Request(s)	No
careManager	Reference(Practitioner\|PractitionerRole)	Care manager/care coordinator for the patient	No
careTeam	Reference(CareTeam)[]	Other practitioners facilitating this episode of care	No
account	Reference(Account)[]	The set of accounts that may be used for billing for this EpisodeOfCare	No

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 / Solution	Create	Read	Update	Search
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

Search for episodes of care using various criteria.

GET Method

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

Production
Preview

GET /EpisodeOfCare?parameter=value

GET /EpisodeOfCare?parameter=value

POST Method

Use POST for complex searches with form-encoded parameters.

Production
Preview

POST /EpisodeOfCare/_search

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:

Parameter	Type	Required	Description	Example
`patient`	reference	Yes	The patient who is the focus of this episode of care	`patient=value`
`date`	date	No	The provided date search value falls within the episode of care's period	`date=value`
`identifier`	reference	No	Business Identifier(s) relevant for this EpisodeOfCare	`identifier=value`
`incoming-referral`	reference	No	Incoming Referral Request	`incoming-referral=value`
`organization`	reference	No	The organization that has assumed the specific responsibilities of this EpisodeOfCare	`organization=value`
`status`	token	No	The current status of the Episode of Care as provided (does not check the status history collection)	`status=value`
`type`	token	No	Type/class - e.g. specialist referral, disease management	`type=value`

ID-based Search:

Parameter	Type	Required	Description	Example
`_id`	string	Yes	The ID of the resource	`_id=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`

Examples

Read EpisodeOfCare

Production
Preview

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

Read EpisodeOfCare by ID
curl -X GET https://fhirtest.netsmartcloud.com/provider/patient-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.

Production
Preview

Search by Patient
curl -X POST https://fhir .netsmartcloud.com/payer/patient-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
curl -X POST https://fhirtest.netsmartcloud.com/payer/patient-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)

Production
Preview

Search by Patient and Status
curl -X POST https://fhir.netsmartcloud.com/payer/patient-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 and Status
curl -X POST https://fhirtest.netsmartcloud.com/payer/patient-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)

Production
Preview

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

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

Response Example

{
  "resourceType": "Bundle",
  "id": "episode-search-results",
  "type": "searchset",
  "total": 1,
  "entry": [
    {
      "resource": {
        "resourceType": "EpisodeOfCare",
        "id": "example-episode-123",
        "status": "active",
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/episodeofcare-type",
                "code": "hacc",
                "display": "Home and Community Care"
              }
            ]
          }
        ],
        "patient": {
          "reference": "Patient/123"
        },
        "period": {
          "start": "2022-01-15T09:00:00.000Z"
        }
      }
    }
  ]
}

Integration Patterns

Common Workflows

Retrieve all episodes of care for a patient to understand their care history
Filter active episodes to identify current care responsibilities
Include provenance data to track episode information sources
Cross-reference with encounters to understand care delivery within episodes

Patient - Individual receiving care during the episode
Organization - Healthcare organization managing the episode
Condition - Medical conditions addressed during the episode
Encounter - Individual care encounters within the episode
Provenance - Source and history tracking

Error Handling

For detailed error codes and handling procedures, see the Error Handling Guide.

Supported Profiles

This resource supports the following FHIR profiles as defined in the CapabilityStatement:

Base FHIR R4 EpisodeOfCare Resource

Overview​

Use Cases​

Relationships​

Resource Schema​

Key Fields​

JSON Example​

Operations​

Read​

Search​

GET Method​

POST Method​

Search Parameters​

Examples​

Read EpisodeOfCare​

Search EpisodeOfCare​

Search by Patient (POST)​

Search by Patient and Status (POST)​

Search by Patient (GET)​

Response Example​

Integration Patterns​

Common Workflows​

Related Resources​

Error Handling​

Supported Profiles​