Thesis
The episode of care
Explains the episode of care as the organising idea that ties a patient's visits, record entries, orders and charges together over time.
The episode of care is the organising idea that ties a patient's visits, record entries, orders and charges together over time. Every tool in Pensieve builds on it.
The unit of care
An encounter is a single contact between a patient and the hospital. The ward calls it a visit or an admission. An outpatient visit is an encounter, and an inpatient stay is an encounter.
An episode of care is one encounter seen over its whole length, from the moment a patient arrives to the moment the visit closes. It is the unit that the rest of a patient's care hangs from.
Gate opens the episode when a patient is registered and a visit begins. From that point, the clinical and business record of the visit attaches to the episode rather than to the patient in the abstract.
What it holds
Diagnoses, orders and charges attach to the encounter, not to the patient directly. Attaching to the episode keeps the reason and the moment of every action, so the record reads as a sequence of decisions with a context around each one.
Conditions recorded during the episode and carried forward in the patient record.
Requests placed within the episode, each frozen to the catalogue as it stood.
Laboratory and imaging findings returned against the episode's orders.
The billable consequences of the episode's work, priced as they stood when raised.
The episode lifecycle
An episode moves through a small set of states. It opens as registered, becomes ongoing once a clinician makes contact, and closes as completed. A registered visit that uses no service closes as cancelled. Completed and cancelled are final.
Discharge carries two conditions
Closing an inpatient episode at discharge draws on clinical readiness and a settled or arranged account together. The record of the episode holds both, so a discharge reads as a decision made with the full picture in view.
The section on the visit lifecycle sets out each state and the moves between them.
One threaded record
An episode belongs to a site, and the patient record that threads episodes together belongs to the patient. It has no owning hospital and follows the patient across every site that runs Pensieve. A clinician at any site reads the same history, so a patient treated across several sites carries one record through all of them.
This is the difference between an episode and a record. An episode is bounded in time. The record is the thread that runs through every episode a patient has.
Why it holds
Attaching work to the episode rather than to the patient gives every entry a reason and a time. A charge points to the episode that produced it. An order points to the episode it was placed in. Access points to a current care relationship, which an episode establishes and closes.
This is the shape the rest of the platform assumes. Billing settles an episode. The record threads episodes. Access opens while an episode is live and closes with it.
Common questions
Is an episode the same as an admission?
An admission is one kind of episode. An outpatient visit is another. The episode is the general term the platform uses for one contact between a patient and the hospital.
Do orders attach to the patient or the episode?
An order attaches to the episode it was placed in. The patient record then threads that order, with every other episode, into one continuous history.
What closes an episode?
A completed episode closes when care finishes, and a registered episode that uses no service closes as cancelled. Both are final, and a correction after that point is a new entry rather than an edit.
Read how the hospital ontology connects an episode to the people and places around it.