The encompassingEncounter XML element in the CDA Header, is used to represent the primary encounter in which the clinical acts being documented in the CDA document took place.

The element’s full path is ClincialDocument/componentOf/encompassingEncounter – where the intermediate componentOf element serves to express the “act relationship” between the ClinicalDocument act element (the XML root element of every CDA document, representing the overall “clinical documentation act” of that CDA document) and the encompassingEncounter act. The syntactical role of componentOf is analogous to that of entryRelationship in other contexts in a CDA document – refer to the article The entryRelationship element, for additional information.

Why an “Encompassing Encounter”?
The encompassingEncounter element in the CDA Header – like all components of the CDA Header – helps provide overall context for the document. It can be helpful to think of the CDA Header in the context of a document repository storing many CDA documents. The header information enables the “meta-data” for the document to be populated for searching, grouping of related documents, etc.

In that context, documents with a shared encompassingEncounter would logically be grouped together, and the information in encompassingEncounter would help identify and search for a specific CDA document.

What is the “Encompassing Encounter”?
For certain types of CDA documents, it is clear what the “encompassing encounter” is. For example, if we consider the C-CDA document templates, a Consultation Note has a clear “encompassing encounter” in which the consultation took place. Thus, componentOf/encompassingEncounter is required to be present as per the rules of the Consultation Note template. Refer to the article Use of encompassingEncounter in C-CDA document templates, for additional information.

Attributes and Sub-Elements of encompassingEncounter
The attributes (classCode and moodCode) and some of the sub-elements (id and code) of encompassingEncounter, are similar to those used in the encounter clinical act statement in the CDA Body – refer to the article The encounter element, for additional information.

The effectiveTime element must be present under encompassingEncounter, and it is required to represent a contiguous time period – refer to the article Time intervals in CDA, for additional information.

The dischargeDispositionCode is a coded element that draws its code values from either the National Uniform Billing Committee Code (NUBC) codes UBC or from an alternative code system defined by HL7 (as NUBC code systems are not public-domain and its use requires membership). A future CDA PRO Know article will cover dischargeDispositionCode in more detail.

Similarly, future CDA PRO Know articles will examine more closely the sub-elements of encompassingEncounter named responsibleParty, encounterParticipant, and location.

Other CDA PRO Know Articles Referenced In This Article