In Healthcare IT, it’s important to understand the concept of episodes of care versus encounters. An encounter is a single event in which care is given. Individual office visits, ER visits, chemo appointments, and C-Sections are all encounters. An episode of care is a grouping of more than one encounter. A pregnancy is an episode that has many encounters as the mom-to-be has her OB visits. A round of chemo treatments for a cancer patient is also an episode. An episode has a start and end date.
Reasons that this is applicable to Healthcare IT include data analysis and reporting and billing. A Healthcare organization can crunch the numbers on episodes over time to learn things like:
- How patient outcomes are trending over time by episode
- How much is being spent per episode
- What external factors may be affecting patient’s health
- How to determine the average number of encounters per episode
Also, the US Healthcare system is moving away from a fee-for-service model where providers are paid only on the procedures and services delivered. This means that insurance companies are moving toward paying a flat fee for an episode of care. Electronic Health Records help providers to adapt to this model.
Check out many more clinical and healthcare IT terms and definitions.