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Establishing a Citizen as a Patient

The Patient resource is a central resource in the eHealth Infrastructure. It plays several different roles:

  • Conveys basic information about the patient (name, address, birth date, gender, civil registration number, demographics information, etc.)

  • Conveys extended information about the patient

    • Contact information

    • Language / Need for an interpreter

    • Temporary addresses

    • General practitioner

Info

A Patient is considered a 'singleton' in the eHealth Infrastructure. The patient is primarily a container for demographic information. While it is allowed according to the FHIR specification to have multiple different logical Patients for the same person, it does not fit the case for the infrastructure and the Danish modelling of patient information. As such, the patient resource is shared across different episodes of care and other clinical resources.

Ensuring a Match Between CRN and Citizen

To verify the correspondence between the Citizen name and CRN, a lookup can be made with a Person name lookup, based on the CRN given in the input Person resource.

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Creating and Maintaining an EpisodeOfCare

Info

See EpisodeOfCare for an introduction to use and elements.

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The EpisodeOfCare is created by invoking $create-episode-of-care on the CarePlan Service.

Preparing Conditions

An EpisodeOfCare relates to one or more conditions. These must be created as part of the $create-episode-of-care operation by including them in the input bundle.

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Prerequisite to activating the EpisodeOfCare, the citizen’s consent to undergo/be enrolled to the EpisodeOfCare and comprised CarePlan resources must be registered in a Consent. The Consent is created through Consent Create and must contain details as described in the Consent introduction.

Activating the EpisodeOfCare

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  • Setting the status to active through an EpisodeOfCare UpdateHTTP-Patch.

  • Setting a status change to active in the EpisodeOfCare.ehealth-statusschedule resulting in an automatic status change in the future.

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EpisodeOfCare.status can be adjusted in two ways through the use of EpisodeOfCare HTTP-Patch (Update is not exposed):

  • Setting EpisodeOfCare.status directly

  • Setting a scheduled status change by updating EpisodeOfCare.ehealth-statusschedule

Allowed status changes:

  • From planned to active, onhold, waitlist, cancelled, or entered-in-error

  • From waitlist active to planned onhold, active, onhold finished, cancelled, or entered-in-error

  • From waitlist to planned, active to , onhold, finished, cancelled, or entered-in-error

  • From onhold to active, finished, cancelled, or entered-in-error

  • From finished to entered-in-error or active

See implementation guide: EpisodeOfCare.status

Info

Enforced constraints on the duration of scheduled status with value onhold.

When setting scheduled status changes it is automatically enforced how long the EpisodeOfCare can be planned as paused (with status set to onhold). This is done to prevent patient plans from being forgotten in a paused state.

When setting EpisodeOfCare.ehealth-statusschedule:

  • If no further status changes are planned by the user, then the infrastructure will automatically insert a planned change back to active 7 days after the start of onhold

  • The maximum duration of a planned onhold status is 30 days.

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  • Through EpisodeOfCare Patch

    • Setting the EpisodeOfCare.team

    • Setting the scheduled team changes in EpisodeOfCare.ehealth-teamschedule

  • Through EpisodeOfCare$update-care-teams

Note

CareTeam Handover and Unhandled Tasks

The CareTeams involved in an EpisodeOfCare have access to the EpisodeOfCare, all CarePlan related to it, and all measurements related to ServiceRequest related to the CarePlan and so on (provided the appropriate Role-based access privileges are present for a user using the CareTeam). For Task resources currently created automatically by the infrastructure, the set of CareTeam involved in an EpisodeOfCare are not designated as Task responsible.

There might, however, still exist Tasks created by other means, for instance, Tasks created on user initiative in a solution. For these, it should be considered whether a change in the set of CareTeam involved in the EpisodeOfCare should also result in adjusting of Task.taskResponsible (by adding CareTeam added to the EpisodeOfCare).

Adjusting the Period

The period in which the EpisodeOfCare is applicable is reflected in the EpisodeOfCare.period. Adjustment of EpisodeOfCare.period is performed through EpisodeOfCare Patch.

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