Concepts/Encounter
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An encounter is a single episode of care between a patient and a facility — an outpatient visit, an admission, an emergency presentation, or a virtual consultation. It is the working context for clinical activity: while an encounter is open, the orders, observations, medications, and notes recorded for the patient are gathered under it.
What it represents
In Care's FHIR-aligned model, an encounter maps to the Encounter resource. It answers four questions about one episode: what kind of interaction it is, where and when it happens, who is on the care team, and — for admissions — how the patient arrived and left.
An encounter is not the patient and not the whole medical record. One patient accumulates many encounters over time; each encounter is the bounded slice of activity for a single episode, and the patient record is the thread that ties them together. Think of the patient as the chart and each encounter as a dated chapter within it.
Lifecycle
An encounter carries a status that reflects where the episode stands. It opens as planned or in_progress, runs through active care, and ends in exactly one terminal state. Care records every transition in a status history, so the journey stays auditable.
planned ──▶ in_progress ──▶ discharged ──▶ completed
▲ │
└───┘ on_hold (pause, then resume)
- planned — the episode is scheduled or expected but has not started
- in_progress — the patient is actively being seen or treated
- on_hold — care is temporarily paused (for example, awaiting results or a bed), then resumes
- discharged — the patient has left the facility; closing paperwork may still be in flight
- completed — the episode is finished and finalized
An episode can also end early without reaching completed: cancelled (called off before meaningful care), discontinued (stopped and will not resume), or entered_in_error (created by mistake and voided). These, along with completed, are the terminal states — once an encounter reaches one, it stops accumulating new clinical activity.
Classification
Two independent axes describe an encounter. Class answers "what kind of visit is this?" and priority answers "how urgent is it?". The two are set separately, so an inpatient admission can be routine and an outpatient visit can be an emergency.
| Class | Meaning |
|---|---|
imp
|
Inpatient — admitted to a bed |
amb
|
Ambulatory — outpatient or clinic visit |
emer
|
Emergency — emergency department presentation |
obsenc
|
Observation — short-stay monitoring |
vr
|
Virtual — teleconsultation |
hh
|
Home health — care delivered at the patient's home |
Priority runs from routine through urgent, emergency, ASAP, and stat, with workflow values such as elective and preop for scheduled care. As with status, a change in class is recorded in its own history.
How it connects
The encounter is the hub that most clinical work hangs off:
- Patient — every encounter belongs to exactly one patient, set when it is created and never changed.
- Facility and location — it is anchored to a facility and tracks the location the patient currently occupies within it, with a full location history behind that.
- Booking — an encounter can originate from a scheduling booking, linking the appointment that brought the patient in to the episode that followed.
- Organizations — each encounter is associated with one or more facility organizations, and that association is what drives who can see and act on it.
- Clinical records — conditions, observations, service requests, medication orders, and notes are all recorded in the context of an encounter.
Permissions
Access to encounters is permission-controlled, and every action on the encounter endpoint is reserved for clinical roles. Listing and retrieving an encounter is also granted when the user can view the underlying patient.
| Permission | Description | System Roles |
|---|---|---|
can_create_encounter
|
Open a new encounter for a patient under a facility | Admin, Doctor, Nurse, Facility Admin |
can_list_encounter
|
List encounters within a facility (clinical data is not exposed through this permission) | Admin, Doctor, Nurse, Facility Admin |
can_read_encounter
|
Retrieve an encounter's non-clinical details | Admin, Doctor, Nurse, Facility Admin |
can_write_encounter
|
Update an encounter, manage its organizations, set facility identifiers, assign care-team members, and restart a completed encounter | Admin, Doctor, Nurse, Facility Admin |
Roles are granted to users through their organization, facility, and patient memberships, and permissions cascade down the organization tree — a role held at a parent organization applies to the facilities and encounters beneath it.
Related
Pages that link here:
- Concept: Concepts/Clinical Notes
- Reference: References/Encounter