Gerard Freriks wrote: > Dear all, > > Am I correct to conclude and propose that: > > - *episode:* situation considered to occupy a time interval > > - there are at least 4 context's in which the term 'Episode' is defined: > disease related (point of view of the patient),
this kind of episode often has vague boundaries, and I think we have to rely on following LINKs in the EHR to find all its pieces. If I get bronchitis that seems to get better before it gets worse every two weeks, is this a single episode or many? I don't think it matters - what matters is being able to find all the information items relating to a given problem. > treatment related (point of view healthcare provider), > adminstrative contact related (point of view of healthcare institution), these two are I think possible to identify as being delimited by known points in time, as long as the provider has a clear rule for when they are providing health care, versus when they are not. They might be providing care in parallel with other providers of course - e.g. Dipak had a good example of patients on weekend leave from a mental health institution, who become the responsibility of the local GP for the weekend, but don't really stop being the responsibility of the institution. > insurance related (point of view payer) How re-imbursing institutions want to define episodes is something I don't know much about, but Tim Churches or someone may have something to add here. How does that work in NL, Gerard? I know there is a mixture of government and private payors. > - sometimes the period is real and enumerated (/dd-mm-yy, ISO 8601 : > 1988Data elements and interchange formats - Information interchange - > Representation of dates and times/), > sometimes indefinite (/one week ago, some weeks ago, ongoing, during, > before, etc, as defined in CEN/TC251 EN1238 Time standard for health > care specific problems/) I think such vague times can only be for clinical use (patient had an "episode" of bronchitis about 2 weeks go, lasting about a week). For billing or other computable purposes such as statistical studies, you have to be able to know which things are in and which are out. - thomas - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
