PA Patient Encounter

Patient Administration Patient Encounter Messages

HL7 V2.x Chapter 3 - Patient Administration - defines messages for events collectively called ADT (admission, discharge and transfer) or sometimes called Patient Encounter Management. HL7 V3 also defines messages for these same events but with several significant changes intended to provide cleaner semantics.

1. Separate patient registration from patient encounter. Modern systems maintain a patient file (patient registry) to provide the 'source of truth' about patients. In the case of a health maintenance organization a patient may be added to the patient registry and information about the patient updated regularly even if the patient does not have an encounter.
2. Separate encounter type from patient. In v2

Patient Encounter Types

• Patient Encounter- An interaction between a patient and healthcare participant(s) for the purpose of providing patient service(s) or assessing the health status of a patient. For example, outpatient visit to multiple departments, home health support (including physical therapy), inpatient hospital stay, emergency room visit, field visit (e.g., traffic accident), office visit, occupational therapy, telephone call.
  • Ambulatory Encounter - A comprehensive term for health care provided in a facility or setting that provides diagnostic, therapeutic and health maintenance services for persons not requiring stays that exceed 24 hours (e.g. a practitioner's office, clinic setting, or hospital) on a nonresident and non-emergency basis. The term ambulatory usually implies that the patient has come to the location and is not assigned to a bed. Sometimes referred to as an outpatient encounter.
  • Emergency Encounter - A patient encounter that takes place at a dedicated healthcare service delivery location where the patient receives immediate evaluation and treatment, provided until the patient can be discharged or responsibility for the patient's care is transferred elsewhere (for example, the patient could be admitted as an inpatient or transferred to another facility.)
  • Field Encounter - A patient encounter that takes place both outside a dedicated service delivery location and outside a patient's residence. Example locations might include an accident site and at a supermarket.
  • Home Health Encounter - A patient encounter where services are provided or supervised by a practitioner at the patient's residence. Services may include recurring visits for chronic or terminal conditions or visit(s) facilitating recuperation.
  • Inpatient Encounter - A patient encounter where a patient is admitted by a hospital or equivalent facility, assigned to a location where patients generally stay at least overnight and provided with room, board, and continuous nursing service.
  • Short Stay Encounter - A patient encounter where the patient is admitted to a health care facility for a predetermined length of time, usually less than 24 hours.
  • Virtual Encounter - A patient encounter where the patient and the practitioner(s) are not in the same physical location. Examples include telephone conference, email exchange, robotic surgery, and televideo conference.