Stream: implementers
Topic: Emergency and inpatient
Nadine Adler (Jul 15 2020 at 06:57):
Hi guys, we are working on a PAC System and now we have a problem with the episode of care. We want to represent an inpatient case as an emergency in episode of care. So there is no possibility for emergency inpatient type. Base information like inpatient is only possible in Encounter, should be in Episode for our Use Case. Just found something in Encounter (Expansion: very small valueSet) but there is the problem with class -> coding -> 1...1 , so linking both inpatient and emergency is not possible. Grateful for any advice :pray:
Lloyd McKenzie (Jul 15 2020 at 17:17):
Episodes generally span encounters, so the notion of "inpatient" doesn't really apply. An episode would be something like a pregnancy or an ongoing cancer or something like that where there are numerous encounters and treatments involved. "inpatient" would be reflected in an Encounter that might be part of the episode of care.
Nadine Adler (Jul 20 2020 at 10:01):
Lloyd McKenzie said:
Episodes generally span encounters, so the notion of "inpatient" doesn't really apply. An episode would be something like a pregnancy or an ongoing cancer or something like that where there are numerous encounters and treatments involved. "inpatient" would be reflected in an Encounter that might be part of the episode of care.
Thanks for the answer. But how is it possible to link both in Encounter when there is the restriction for 1...1 coding?
Vassil Peytchev (Jul 20 2020 at 12:35):
Aren't those two separate encounters, where the emergency encounter is part of an inpatient encounter, or the two encounters (emergency, followed by inpatient) are part of the the same episode of care?
Nadine Adler (Jul 22 2020 at 15:18):
Vassil Peytchev said:
Aren't those two separate encounters, where the emergency encounter is part of an inpatient encounter, or the two encounters (emergency, followed by inpatient) are part of the the same episode of care?
Hi, we just want to build the case, that the patient is an emergency case at the beginning and due tot that the data is not complete or valid. But when the data comes in and is valid and complete, the status of the patient switches to inpatient. But this happens in the case itself, i.e. in the treatment phase. We therefore need a double identification, but in encounter is just the coding 1...1 possible
Vassil Peytchev (Jul 22 2020 at 15:33):
The question remains - why is that not one episode that has two encounters - a emergency encounter and an inpatient encounter? The Episode represents the case, and both encounters point to it via Encounter.episodeOfCare?
Lloyd McKenzie (Jul 22 2020 at 16:37):
The "switch of status" in FHIR would be represented as the creation of a new Encounter. If you come into Emergency and then get admitted, that's not a change of status, that's two Encounters.
Nadine Adler (Jul 23 2020 at 07:14):
Okay, now I got it. So it's necessary to build two encounters that refer to one Episode of Care. Thought it could be possible to just have one encounter for both statuses. So it's clear that it works with the 1..1 coding.
Thank you guys for the clarification :pray: Have a great day
Last updated: Apr 12 2022 at 19:14 UTC
