Resource type: location

Description

Details and position information for a physical place where services are provided and resources and participants may be stored, found, contained, or accommodated.

Elements

PathShortDefinitionComments
Details and position information for a physical placeDetails and position information for a physical place where services are provided and resources and participants may be stored, found, contained, or accommodated.
identifierUnique code or number identifying the location to its usersUnique code or number identifying the location to its users.
statusactive | suspended | inactiveThe status property covers the general availability of the resource, not the current value which may be covered by the operationStatus, or by a schedule/slots if they are configured for the location.
operationalStatusThe Operational status of the location (typically only for a bed/room)The Operational status covers operation values most relevant to beds (but can also apply to rooms/units/chair/etc. such as an isolation unit/dialysis chair). This typically covers concepts such as contamination, housekeeping and other activities like maintenance.
nameName of the location as used by humansName of the location as used by humans. Does not need to be unique.If the name of a location changes, consider putting the old name in the alias column so that it can still be located through searches.
aliasA list of alternate names that the location is known as or was known as in the pastA list of alternate names that the location is known as or was known as in the past.There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the location.
descriptionAdditional details about the location that could be displayed as further information to identify the location beyond its nameDescription of the Location, which helps in finding or referencing the place.
modeinstance | kindIndicates whether a resource instance represents a specific location or a class of locations.This is labeled as a modifier because whether or not the location is a class of locations changes how it can be used and understood.
typeType of function performedIndicates the type of function performed at the location.
telecomContact details of the locationThe contact details of communication devices available at the location. This can include phone numbers, fax numbers, mobile numbers, email addresses and web sites.
addressPhysical locationPhysical location.Additional addresses should be recorded another instance of the Location resource, or via the Organization.
physicalTypePhysical form of the locationPhysical form of the location, e.g. building, room, vehicle, road.
positionThe absolute geographic locationThe absolute geographic location of the Location, expressed using the WGS84 datum (This is the same co-ordinate system used in KML).
position.idUnique id for inter-element referencingUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
position.extensionAdditional content defined by implementationsMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
position.modifierExtensionExtensions that cannot be ignored even if unrecognizedMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
position.longitudeLongitude with WGS84 datumLongitude. The value domain and the interpretation are the same as for the text of the longitude element in KML (see notes below).
position.latitudeLatitude with WGS84 datumLatitude. The value domain and the interpretation are the same as for the text of the latitude element in KML (see notes below).
position.altitudeAltitude with WGS84 datumAltitude. The value domain and the interpretation are the same as for the text of the altitude element in KML (see notes below).
managingOrganizationOrganization responsible for provisioning and upkeepThe organization responsible for the provisioning and upkeep of the location.This can also be used as the part of the organization hierarchy where this location provides services. These services can be defined through the HealthcareService resource.
partOfAnother Location this one is physically part ofAnother Location which this Location is physically part of.
hoursOfOperationWhat days/times during a week is this location usually openWhat days/times during a week is this location usually open.This type of information is commonly found published in directories and on websites informing customers when the facility is available. Specific services within the location may have their own hours which could be shorter (or longer) than the locations hours.
hoursOfOperation.idUnique id for inter-element referencingUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
hoursOfOperation.extensionAdditional content defined by implementationsMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
hoursOfOperation.modifierExtensionExtensions that cannot be ignored even if unrecognizedMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
hoursOfOperation.daysOfWeekmon | tue | wed | thu | fri | sat | sunIndicates which days of the week are available between the start and end Times.
hoursOfOperation.allDayThe Location is open all dayThe Location is open all day.
hoursOfOperation.openingTimeTime that the Location opensTime that the Location opens.
hoursOfOperation.closingTimeTime that the Location closesTime that the Location closes.
availabilityExceptionsDescription of availability exceptionsA description of when the locations opening ours are different to normal, e.g. public holiday availability. Succinctly describing all possible exceptions to normal site availability as detailed in the opening hours Times.
endpointTechnical endpoints providing access to services operated for the locationTechnical endpoints providing access to services operated for the location.

Scope and Usage

A Location includes both incidental locations (a place which is used for healthcare without prior designation or authorization) and dedicated, formally appointed locations. Locations may be private, public, mobile or fixed and scale from small freezers to full hospital buildings or parking garages.

Examples of Locations are:

These locations are not intended to cover locations on a patient where something occurred (i.e. a patient's broken leg), but can happily cover the location where the patient broke the leg (the playground)

Boundaries and Relationships

Locations and Organizations are very closely related resources and can often be mixed/matched/confused.
The Location is intended to describe the more physical structures managed/operated by an organization, whereas the Organization is intended to represent the more conceptual hierarchies, such as a ward.

A Location is valid without an address in cases where it could be purely described by a geo-coded location in remote areas, or when recorded by a device. Locations with a mode = "kind" would also likely not have an address, as they are just a type of location, but could also have an address where they can be found at the address.

Another use of location could be for describing a Jurisdiction. This jurisdiction may be considered a classified boundary which could be a combination of a physical boundary, and some other discriminator(s):

Notes

Location Mode

The Location.mode element can be used to indicate whether a Location resource represents a specific (potentially identifiable) Location ('instance'), or a class of Locations ('kind'). Especially Resources capturing orders, resource scheduling, plans and definitions may refer to Locations in 'kind' mode. For these domains, it is often not necessary to refer to a specific Location, but rather to a class of Locations. An example of this is found in planning, where we need to allocate an "isolation room" for a patient, or need to dispatch "an ambulance" at a certain time. In these cases it is not important exactly which isolation room or ambulance is allocated, and it is sufficient to just indicate a 'kind' of Location.

Note that 'kind' should not be used to represent Locations where an actual instance of a Location was involved, but identifying information is missing. E.g. when a patient arrived 'by ambulance', but it is not known by which ambulance, this should be represented using a Location in 'instance' mode with a missing identifier, not a Location of 'kind' ambulance.

Some of Location's data elements are only relevant when mode is 'instance' and should not be used when mode is 'kind':
(however this information could still be included if was relevant, such as when it is a generic item, but not globally generic, e.g. a Burgers MU ambulance)

Example Location Hierarchy

An example location hierarchy should help give some guidance as to one example of how a location hierarchy could look within a fictitious Hospital.
(The nesting here would be the "part-of" structure of the location)

Hospital A Building C (instance)
    East Wing (instance)
        Level 1 (instance)
            Reception (instance)
            Nurses Station EM-ns1 (instance)
                Medication Cupboard A (instance)
            Room 1 (instance)
                Room 1a (instance) - space in room separatable via a curtain
                    Bed 1a (instance) - always in this room
                Room 1b (instance)
                    Trolley 43 (instance) - moves about
                Room 1d (instance)
                    Trolley 19 (instance) - moves about
                Room 2 (instance)
                    ...
            Theatre EM-TA (instance)
            Coridor (generic)
        Level 2 (instance)
            Reception (instance)
                ...
            Nurses Station EM-ns1 (instance)
                Medication Cupboard A (instance)
            Coridor (generic)
Mobile Services (kind)
    Ambulance (kind)
        Ambulance AMB1 (instance)
        Ambulance AMB2 (instance)
	

Note: Wards/departments are not part of this structure - these would form part of the Organizational Hierarchy.

Positional Searching

Searching for locations often require that a facility is within a specified distance of a specified point. For example, to locate healthcare facilities within 11.2 kms of a client's home, or the current geo-coded position of a practitioner travelling between patients (read from a mobile phone or device).

 GET [base]/Location?near=-83.694810|42.256500|11.20|km...

The distance and distance unit parameter components are optional, if the units are missing, kms are to be assumed. If the distance parameter component is missing, then the server may choose its own interpretation of what near enough is to be included in the search results.

Note: The STU3 version of this functionality did not support the multiple multiple separator , or chaining. The update to this format now supports both these use cases.
(And the near-distance was deprecated as a result of this change too)

The distance between the location and the provided point is often used as one of the determining factors for selection of the location. So this value is included in the results.
However the value cannot be inside the Location resource as it is different depending on the point of reference in the search. So the distance between is included in the search section of the bundle entry. Where multiple near positions are included, the distance to the closest point provided may be included.

<entry> 
    <resource>
        <Location>
            <!-- location details -->
        </Location>
    </resource>
    <search>
        <extension url="http://hl7.org/fhir/StructureDefinition/location-distance">
            <valueDistance >
                <!-- The distance that this location resource is from the provided point in the query --<
                </value value="10.5"/>
                </unit value="km"/>
            </valueDistance>
        </extension>
    </search>
</entry> 

Search Parameters

addressA (part of the) address of the locationLocation.address
address-cityA city specified in an addressLocation.address.city
address-countryA country specified in an addressLocation.address.country
address-postalcodeA postal code specified in an addressLocation.address.postalCode
address-stateA state specified in an addressLocation.address.state
address-useA use code specified in an addressLocation.address.use
endpointTechnical endpoints providing access to services operated for the locationLocation.endpoint
identifierAn identifier for the locationLocation.identifier
nameA portion of the location's name or aliasLocation.name | Location.alias
nearSearch for locations where the location.position is near to, or within a specified distance of, the provided coordinates expressed as [latitude]|[longitude]|[distance]|[units] (using the WGS84 datum, see notes). If the units are omitted, then kms should be assumed. If the distance is omitted, then the server can use its own discression as to what distances should be considered near (and units are irrelevant) Servers may search using various techniques that might have differing accuracies, depending on implementation efficiency. Requires the near-distance parameter to be provided alsoLocation.position
operational-statusSearches for locations (typically bed/room) that have an operational status (e.g. contaminated, housekeeping)Location.operationalStatus
organizationSearches for locations that are managed by the provided organizationLocation.managingOrganization
partofA location of which this location is a partLocation.partOf
statusSearches for locations with a specific kind of statusLocation.status
typeA code for the type of locationLocation.type

Extension Definitions

These are extension definitions for this resource defined by the spec