[Gnumed-devel] Encounter, Encountlet, Episode, Health issue, Problem

[James Busser]

For reconciliation if we are understanding these differently:


Encounter = interaction with the patient (record), involving the  
patient directly or indirectly. Examples: in-person visit; phone  
call; review of chart / results.

Encountlet ("...let" denoting "portion") = the { S | O | A | P }  
portion(s) of a multi-issue encounter that pertains to a particular  
problem or a particular health issue. In the case of a single-issue  
encounter, the encountlet *is* the encounter.

Episode = for any problem(s) or issue(s), a set of one or more  
encounters where the "last-in-set" denotes a definite or apparent or  
expected natural ending. Examples:  death; resolution of symptoms /  
findings. Episodes remain "open", i.e. without a designated "end",  
until the clinician decides to mark them "closed", which may happen  
only when the patient returns for an unrelated reason and confirms  
whether the other has in the meantime subsided.

Health issue: one or more clinically-related episodes of care,  
aggregated under a clinically-suitable grouping name (diabetes,  
hypertension, chronic kidney disease, lupus). Note that among a  
patient's episodes, some will involve an as-yet undiagnosed set of  
complaints, which can often be self-limited and so not all episodes  
will get aggregated under a health issue.

Problem: open (active) episodes, and any health issues that, even if  
"inactive" (no open episodes), are of potential importance