Concepts/Encounter

conceptclinicalFHIR: EncounterCARE 3.0+

An encounter in Care records one interaction between a patient and your facility. The interaction is an outpatient visit, an admission, an observation stay, an emergency visit, a virtual consultation, or a home visit. The encounter groups everything the care team records for that interaction. A patient can have more than one open encounter at the same facility at the same time.

📝 Note

Your deployment sets the maximum number of open encounters for one patient at a facility. The default maximum is 5.

Care follows the FHIR R5 Encounter resource. An encounter links to these records:

The patient who receives the care.
The facility and the departments that answer for the care.
The location that the patient occupies.
The appointment that starts the encounter.

Key Attributes

Components	What it captures
Status	The current state of the encounter, for example In Progress.
Type of Encounter	The type of care, for example Inpatient or Ambulatory. The update form calls this field Encounter Class.
Priority	The urgency of the care, for example Emergency or Routine.
Date and Time	The date and time when the encounter starts.
Discharge Date and Time	The date and time when the facility discharges the patient.
Hospital Identifier	A free-text reference number that your facility uses, such as an IP, OP, OBS or EMR number.
Departments	The facility departments that answer for the encounter.
Care team	The staff who look after the patient, each with a clinical role.
Current location	The bed, room or ward that the patient occupies.
Tags	Labels that your facility configures.
Hospitalization details	The admission and discharge information for a patient who stays at the facility.
Discharge Summary Advice	Free text that the team writes for the patient at discharge.

Departments

Each encounter needs at least one department. The departments control who can see the encounter. To change them, see Manage Encounter departments.

Care team

The care team lists the staff who look after the patient. Each member holds a clinical role. One member carries the primary marker. To change the team, see Manage the Encounter care team.

Type of Encounter

Type of Encounter	Description
Inpatient	Patient is admitted to the hospital.
Ambulatory	Patient visits for outpatient care.
Observation	Patient is under observation.
Emergency	Mark as emergency if immediate attention is required.
Virtual	Virtual/telehealth consultation.
Home Health	Care provided at patient's home.

📝 Note

Your deployment decides which types staff can choose. Your deployment also decides which type Care preselects.

Priority

The priority states how urgent the care is. Care offers these priorities:

Stat
ASAP
Emergency
Urgent
Routine
Elective
Rush reporting
Timing critical
Callback results
Callback for scheduling
Pre-op
As needed
Use as directed

📝 Note

Routine is the default priority on the create form.

Hospitalization details

Hospitalization details appear only for the Inpatient, Observation and Emergency types.

Components	What it captures
Re-Admission	Whether the patient comes back for the same problem.
Admit Source	Where the patient came from.
Discharge Disposition	Where the patient goes after discharge.
Diet Preference	The dietary requirement of the patient.

Admit Source offers these values:

Transferred from other hospital
From accident/emergency department
From outpatient department
Born in hospital
General Practitioner referral
Medical Practitioner/physician referral
From nursing home
From psychiatric hospital
From rehabilitation facility
Other

Discharge Disposition offers these values:

Home
Alternate home
Other health care facility
Hospice
Long term care
Left against advice
Expired
Psychiatric hospital
Rehabilitation
Skilled nursing facility
Other

Diet Preference offers these values:

Vegetarian
Dairy free
Nut free
Gluten free
Vegan
Halal
Kosher
None

📝 Note

Your deployment can set a default discharge disposition. Care pre-fills that value.

Status

The status shows where the encounter is in its life cycle.

Status	Description
Planned	The team plans the encounter for a future date.
In Progress	The team gives care to the patient now.
On Hold	The team pauses the encounter.
Discharged	The facility discharges the patient.
Completed	The care in this encounter ends.
Cancelled	The team cancels the encounter before the care starts.
Discontinued	The team stops the encounter before the care ends.
Entered in error	A user creates the encounter by mistake.
Unknown	The status of the encounter is not known.

Care applies no rules about the order of the statuses. While the encounter stays open, you can move it from any status to any other status.

Four statuses lock the encounter: Completed, Cancelled, Discontinued and Entered in error. After the encounter reaches one of these statuses, nobody can edit it. Nobody can record new clinical data on it.

Discharged does not lock the encounter. A discharged encounter stays open for edits. The care team can still change the location, the care team, the departments and the tags. To close a discharged encounter, someone must mark it as complete. See Complete an Encounter.

📝 Note

Your deployment sets how long after its last change someone can restart a completed encounter. The default is zero hours, which stops all restarts.

Where to find Encounters

The facility sidebar holds a Patients group. The group contains Search Patients, one list for each allowed encounter type, and Locations. The group also contains All Encounters when your deployment allows more than one encounter type.

📝 Note

Your deployment sets the default date filter on the encounter lists.

The encounter page holds these tabs: Overview, Plots, Observations, Medicines, Responses, Service Requests, Diagnostic Reports, Files, Notes, Devices and Consents. Every tab except Overview, Devices and Consents needs permission to read clinical data.

The encounter page also holds an Encounter Actions command palette. Press Shift+E to open it.

The Overview tab carries a side panel with these actions:

Manage Consents
Manage Care Team
Update Location
Update Department
Dispense

The Overview tab also carries a button. The button reads Mark for discharge or Mark as Completed.

A left rail lets you move between the encounters of the patient. The rail filters the encounters by status, department, care team, date and tags.

Permissions

Your role controls what you can do with an encounter. Administrators, Doctors, Nurses and Facility Administrators hold these permissions.

Permission	What it allows
Can Create encounter	Create an encounter.
Can Read encounter	Open an encounter.
Can list encounters	See the encounter lists.
Update Encounter non clinical	Change the details of the encounter. Manage its departments, care team, location, tags, completion and restart.
Can Read encounter related clinical data	Open the clinical tabs.
Update Encounter related clinical data	Record clinical data.
Can submit questionnaire about patient encounters	Answer questionnaires about the encounter. Staff also hold this permission.

You can also reach an encounter through the department that owns the current bed of the patient. The departments of the encounter are not the only route.

Pages that link here:

Concept: Concepts/Care team
Reference: References/Encounter

Key Attributes

Departments

Care team

Tags

Type of Encounter

Priority

Hospitalization details

Status

Where to find Encounters

Permissions

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