Playbooks/Palliative/Playbooks/Palliative patient enrollment

playbookpalliativeCARE 3.0+

Enroll a patient into a community or facility-based palliative program. This playbook combines the register patient flow with palliative-specific intake, caregiver capture, and program assignment.

Flows involved

Order	Flow	Purpose
1	Register a patient	New patient with no existing record
2	Patient search	Match returning patients before creating duplicates
3	Palliative program enrollment (coming soon)	Assign program, care team, and visit cadence

Happy path

1. Community nurse or intake coordinator searches by phone, national ID, or name.
2. No match → Register new patient → complete demographics and primary diagnosis.
3. Record primary caregiver name, phone, and relationship.
4. Assign palliative program (home-based, facility, or hybrid).
5. Schedule first assessment visit and document consent for palliative care.

Edge cases

Referred from hospital IP

Symptom: Discharge summary lists patient; family requests home palliative follow-up.

Action:

1. Search by hospital MRN or phone from referral slip.
2. If patient exists → open record and add palliative program enrollment; do not create a duplicate.
3. Import or attach discharge summary and active medication list.
4. Flag transition of care for the assigned community nurse.

Patient already in HMIS

Symptom: Same person registered at hospital OPD; palliative program runs on a shared Care instance.

Action:

1. Search existing HMIS record.
2. Enroll in palliative program without duplicating demographics.
3. Document palliative-specific goals of care separately from acute encounter notes.

Caregiver-only contact at intake

Symptom: Family member calls; patient is bed-bound and cannot attend facility.

Action:

1. Register patient with available demographics.
2. Add caregiver as related contact with callback number.
3. Mark intake as pending patient verification until first home visit.
4. Schedule home visit as first clinical contact.

Limited demographics (rural outreach)

Symptom: Camp intake collects phone and village only.

Action:

1. Register with minimum fields allowed by facility questionnaire.
2. Flag incomplete demographics.
3. Complete address and ID verification on first home visit.

Roles

Role	Can
Palliative intake coordinator	Search, create, enroll in program
Community nurse	Update care plan, document home visits
Palliative physician	Approve program enrollment, adjust care goals
Registration clerk (shared HMIS)	Search and link existing hospital records

Related

Open Healthcare Network's flagship product: an open-source, FHIR-native electronic medical record (EMR) and healthcare operating system.

Hospital Management Information System — software covering registration, encounters, labs, pharmacy, billing and reporting.