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Clarification Needed: Does CH Core Encounter Represent a Swiss “Fall”? #431

@luisfabib

Description

@luisfabib

There is ongoing discussion at the USZ and some uncertainty regarding how the HL7 FHIR CH Core Encounter profile is intended to be used in the Swiss context (specifically whether it corresponds to what is commonly referred to in German as a “Fall” administrative case).

Problem

The current interpretation appears to suggest that the CH Core Encounter may represent a Fall, as evidenced by the presence of the identifier slice VisitNumber, which is described as Visit number (Fallnummer), namely here

* identifier[VisitNumber] ^short = "Visit number (Fallnummer)"

This wording implies alignment with the Swiss administrative concept of a Fall. However, this raises modeling questions.

In our understanding, in Swiss healthcare systems, a Fall is typically understood as an administrative construct, often used for billing and case management purposes. Within HL7 FHIR, such constructs are frequently modeled using the Account resource, which can aggregate financial and administrative information and may reference one or more Encounter resources.

This leads to ambiguity:

  • Should a Swiss Fall be represented as an Encounter (as implied by CH Core)?
  • Or should it be modeled as an Account, with one or more associated Encounter resources representing the clinical interactions?

Key Questions

  1. Is the intent of the CH Core Encounter profile to represent a Fall in the Swiss administrative sense?
  2. If so, how should implementers handle scenarios where multiple clinical encounters belong to a single administrative Fall?
  3. Would it be more appropriate (or aligned with FHIR best practices) to model the Fall as an Account, with Encounter used strictly for individual care events?
  4. Are there official guidelines or examples that clarify this distinction within CH Core? Or could a better description/narrative be added to the profile?

Proposed Clarification

It would be helpful to:

  • Explicitly document whether CH Core Encounter is intended to represent a Fall.
  • Provide guidance on when to use Encounter vs Account in Swiss implementations.
  • Include example scenarios demonstrating recommended modeling patterns.

I would greatly appreciate any advise on the intended modeling approach or provide references to existing guidance. Thank you!

P.S. This is my first issue for this IG project. Please let me know if issues such as this should belong in another place or forum.

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