Patient Encounter

 

A Patient Encounter describes an interaction between a Patient and a healthcare provider. A Patient Encounter spans a period of time, the length and detail of which may vary according to local procedures and conventions. Examples may be: Inpatient Stay, Outpatient Visit, Patient's General Practitioner Visit, Telephone Consultation.

Technical Data

Entity Type

Business Object

Software Component Version

ESM ERP 606

Technical Name

PatientEncounter

Object Category

Business Process Object

Business Context and Use

Overview

The Patient Encounter business object is used to manage information on a patient's stay in the hospital. A patient ( Patient business object) is assigned to a patient encounter, which is then assigned to a billing patient encounter group ( Billing Patient Encounter Group business object. If no billing patient encounter group exists when a patient encounter is created, the system also creates an instance of the  Billing Patient Encounter Group business object. A patient encounter is uniquely identified by a PatientEncounterID.

Patient encounters are delimited by events such as admission, discharge, and transfer.

There are four categories of patient encounter, specified by the CategoryCode element:

  • Inpatient Stay (CategoryCode with value '01')

  • Absence (CategoryCode with value '02')

  • Visit (CategoryCode with value '03')

  • Procedural Visit (CategoryCode with value '04')A procedural visit is a visit for the purpose of a planned medical procedure (for example, an X-ray).

The Patient Encounter Management process component provides service operations to maintain and search for patient encounters, and to view the details of patient encounters.

Use Cases 

  1. A nurse admits a patient, but does not know when the patient will be discharged. The nurse enters any information that is available, and the Create Patient Encounter service operation is called to create an instance of the Patient Encounter business object of category 'Inpatient Stay' for the patient. However, no end date is specified. Five days later, the patient has been treated and the discharge date is now known. The nurse again enters the system and adds the discharge date to the patient encounter, which is carried out using the Update Patient Encounter service operation. The back-end creates a discharge for the patient.

  2. A nurse admits a patient, knowing when the patient will be discharged. The Create Patient Encounter service operation is called, as above, to create the instance of the Patient Encounter  business object (including the discharge date). However, the patient must later be transferred to another department. The nurse enters the transfer into the system and adds the relevant organizational data that specifies the new organizational unit. On creating the transfer, the  Create Patient Encounter operation is called again and creates the transfer in the back-end system.

Notes on SAP Implementation

Mapping of Patient Encounter Categories to Movement Categories in SAP Patient Management

This section explains how the four patient encounter categories are derived from the six movement categories in the SAP Patient Management back-end system.

In SAP Patient Management, the following movement categories exist: 

  • Admission (movement category 1)

  • Transfer (movement category 3)

  • Discharge (movement category 2)

  • Start of Absence (movement category 6)

  • End of Absence (movement category 7)

  • Outpatient Visit (movement category 4)Including sub-types such as 'Outpatient Surgery'

'Inpatient Stay' patient encounters describe a period in time, delimited by the following movements in SAP Patient Management:

  • The period starting from an admission movement only (no end date of the inpatient stay specified)

  • The period between an admission movement and a discharge movement

  • The period between an admission movement and a  transfer movement

  • The period between a transfer movement and a transfer movement

  • The period between a transfer movement and a discharge movementThese periods are determined by the start and end date of the patient encounter, and can be controlled either when creating the encounter (using the Create Patient Encounter service operation), or when changing the encounter (using the Update Patient Encounter service operation).

'Absence' patient encounters run in parallel to inpatient stays and do not interrupt them. They correspond to the following movements in SAP Patient Management:

  • Start of absence and end of absence

'Visit' patient encounters correspond to:

  • One outpatient visit movement (containing the start and end time of the visit) of any type other than outpatient surgery

'Procedural Visit' patient encounters correspond to:

  • One outpatient surgery movement (containing the start and end time of the visit) of type outpatient surgery

Terminology Mapping

  • Billing patient encounter group maps to the SAP Patient Managment concept case

  • HospitalParty maps to the SAP Patient Management concept institution

Customizing

  • Several elements of this business object (treatment codes, movement types, referral type, external codes, and so on) require you to make Customizing settings to map external data to internal data. You make these settings in Customizing for SAP Healthcare - Industry-Specific Components for Hospitals under Communication -> Preparation for Service-Enabling  -> Inbound Processing -> Assign GDTs to Customizing Data -> Patient Encounter.

  •  You must maintain the supplementary component (SC) information for internal and external identifiers. For more information on SCs, see Scheme Attributes at IDs and Codes . Find the Customizing for supplementary components in SAP Healthcare - Industry-specific Components for Hospitals  under Communication -> Preparation for Service Enabling -> Inbound Processing -> Maintain Validation Parameters -> Maintain Business Object Identification. The context NBEW - LFDNR is used for the internal identification, and the context NBEW - BEXNR is used for the external identification.