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This information pertains to VetView Version 1.6.1

Info
titleWhat are Episode Types?

Episode Types are the standard set of episodes for use within your hospital.  Because the settings for each episode can be customized for your hospital, it will be important to build consensus among all units as to what the requirements for each standard type of episode will be.  This information is populated in several places, such as the Appointment Type Setup for each unit, and the Episode Header for each patient record.

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You can set up appointments for Outpatients, Inpatients, Tech Appointments, Purchase Only, etc.  You can also go more granular and define different rules for episodes in different service areas, such as episodes specific to large animals, or to your behavior therapy services.

Episodes can be linked to Appointments via the unit's Appointment Type Setup.  See Setting Up Your Units for how to link appointment types to episode types for each unit.

Click on Add Episode Type to begin defining a new episode type.  A window pane with three tabs will appear to the right of the list of episodes.  

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titleEpisode Type Details

Episode Type: This is the name of the episode as it will appear throughout the system.  If similar types of episodes will have different requirements between different units, be sure to create separate episode types for them with unique names.

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Episode Type Setup 

Episode Types in VetView are the underlying structure of a given patient visit in VetView.  These define the background processes that occur when a patient is checked in or discharged, communications to the owner and referring clinic, what parts of the patient medical record will be required by Medical Records, and how a linked appointment type will eventually transform to a visit when the patient arrives.  

Unlike Appointment Types, which are customized for each Hospital Unit, the Episode Types are shared across all units. 

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Add Episode Type

Click on the Add Episode Type button to create a new episode type.  At a minimum, you must have a name to be able to save this episode type.  The episode type will not become available to use until it is linked to an Appointment Type within a unit on the Unit Setup tab. 

Once you have Saved, the Episode Requirements tab will become available.

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Episode Type Details

The Episode Type Details are the basic information and actions that will occur as a patient progresses through a visit.

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FieldDescription
Episode Type:The name that will appear in the Appointment Type list.  These should be short and clear.
DescriptionA longer description of the episode type, such as the requirements based on your hospital's policies
Active FlagWhether this episode type is active.  Episode types cannot be deleted once

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titleEpisode Requirements

Episode Requirements

In VetView, the Episode Requirements control the display of the medical record for each episode type.  These requirements also drive the Medical Record Deficiencies for each episode.

Medical Record Groups are defined under Medical Record Setup. 

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Episode Type: The type you are currency working with.  This cannot be modified on this tab but is included for informational purposes.

Record Group: The name of the medical record group you are adding to this episode.  Assigned People and Billing should be included at a minimum on all episodes. 

Display: This flag indicates that the record group will always be visible on the electronic health record for this type of episode, even if nothing has been added to it yet. If an item is not set to display at a minimum, it will be removed from the list.

Required: This indicates that the medical record group will require a custom document to be added.  For example, your field site visits may require an additional travel form under Assigned People that your inpatient types do not need.  You can set this to be Required on this episode type.

Verify:  This flag means that the documents added to this section will need to be approved by a supervising clinician.  If there are not verifiable documents in your unit (as defined under Catalog Setup), then leave this flag off. 

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titleEpisode Type Events

Episode Type Events

This section allows you to fire off specific actions within VetView based on triggers on the medical record.  

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These notifications are highly customizable and can automate many communications to RDVM and to clients, as a patient's episode progresses through various statuses.

Note that Auto Send means the information will be sent immediately when the action is completed and any attached documents are verified.  If this is unchecked, then the Event will add the communication to the Comm Worklist, where it can be previewed and edited before being sent out by a client or RDVM coordinator. 

Always Send indicates that this communication will send on the requested event, even if there is no document that qualifies or no medical record category included.  This may be useful for a notice of admittance to an RDVM for an emergency referral, for example. 

Macros on this page allow you to insert placeholders along with static text.  The placeholders will pick up and pull in the patient and client's unique information, customizing the letter for the recipient. 

"Message RDVM/Clinic" will go to any clients on a patient that have the Set Medical Record Communication flag turned on on the Patient Contacts page:  Image Removed

"Message Owner" will go to any contacts on the patient record that have the Owner Communications flag turned on: Image Removed

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they have been saved, but they can be modified, and ones that will no longer be used can be set as inactive to preserve historical data.  Changes made to Episode Types will apply to all episodes created with that type going forward, but should not impact any episodes already in the system.
AVMA Reporting TypeThis flag indicates that episodes of this type are valid for AVMA reporting.  For example, a referral episode type may qualify as a new AVMA visit, but a follow-up to a surgery may not.  These distinctions should be defined in accordance with your hospital's policies for reporting purposes.  Field Service episodes are intended to be used by traveling clinical staff for episodes that take place outside of the hospital campus or satellite campus, such as farm visits.
Auto Episode Actions
  • Auto Discharge Episode when order closes: The episode associated with this order will go to a Normal Discharge status when the order is closed.   This flag should be safe to use for bill only episodes, where Close & Payment of the order is likely to occur on the same day as the episode.  This flag can also be used for routine outpatient visits, to avoid having open episodes for longer than necessary.
  • Auto Close Episode on Discharge:  For simple bill only episodes that are unlikely to have a deficiency, such as a pharmacy refill, you can turn this flag on to change the status from Discharged to Closed immediately without further action. 
  • Auto Admit Patient:  For episode types where the patient is likely to be admitted immediately after check-in, such as emergency services, you can designate this episode type as skipping the Check-In step and going straight to Admitted. The Open date and Admit date time stamps will be the same.
Change Episode Type on Admit ToFor an episode type that starts as non-admit episode (standard check-in/open episode), you can have that episode type transform to a different type if the clinical staff admits the patient.  This will automatically change the requirements on the episode, as well as change the underlying type to its AVMA reporting if necessary.
Settings for Adding and Removing to the Census
  • Check-in:  Do nothing, automatically add to the census, show a prompt asking if the user wants to add to the census with add selected by default, or show prompt and do not add by default.  Do nothing means the patient will not be added to the Patient Census.  Use Do Nothing for outpatient episode types where the patient does not accrue board charges and does not need to be tracked by Patient Location.
  • Admit: Do nothing, automatically add to the census, show a prompt asking if the user wants to add to the census with add selected by default, or show prompt and do not add by default.  Do nothing means the patient will not be added to the Patient Census.
  • Discharge:  Do nothing, automatically remove from the census, show prompt and remove by default, or show prompt and do not remove by default.  Do nothing means that if the patient was on the Patient Census, they will not be removed.
  • Order Closed:  Do nothing, automatically remove from the census, show prompt and remove by default, or show prompt and do not remove by default.  Do nothing means that if the patient was on the Patient Census, they will not be removed.  This status may be preferable to Discharge, if Post Board occurs on a nightly basis and the final order has not yet been completed when the patient is discharged.  Discuss the best practices for this with your accounting team.

Episode Requirements

Episode Requirements define the portion of the medical record that will appear for the selected episode type.  The requirements may be very minimal, such as only requiring a patient order on a pharmacy refill, or they can be extensive, such as requiring a full History, Physical, Vitals, Diagnosis, and Discharge for a patient surgery.  

Episode requirements have three settings:  Display Label, Required, and Verify.

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  • Display Label:  This medical record category will automatically appear on the episode, but the document or request does not need to be added.  It can be used as a prompt to consider adding an appropriate document.
  • Required:  This medical record category will automatically appear on the episode.  Someone on the clinical staff must add a document or request that matches the medical record category to fulfill the requirement.
  • Verify:  The medical record category will automatically appear on the episode.  Someone on the clinical staff must add a document or request that matches the category, and this document or request must be approved by a faculty member or order supervisor.

If an episode does not have a Required or Verified document or request within the category, then it is considered Deficient and flags will appear throughout the system until the issue has been resolved.

For more information on verifying Documents and Requests on an episode, please see How to get my Documents and Requests Verified

Add Requirement

Click on the Add Requirement button to add a new medical record category to this episode type.  A blank Add window will appear.

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Select the new Medical Record Category from the drop down menu.  (These categories can only be added to each episode type once.)  Choose the level of requirements, and then click on the Save button.  The new episode requirement will appear in the list.

Edit Requirement

To change an existing requirement, click on the row you want to modify, and then click on the Edit Requirement button.  Make the change and then click on the Save button.

Changes made to these requirements only impact new episodes going forward.

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Episode Events

Episode events are the communications that queue for RDVMS and owners certain steps occur during the patient's visit.   These communications can fire off immediately for routine reports to RDVMs, or can be reviewed and customized in the case of a Discharge that is being handled by a student.  Whereas the Episode Requirements directly impact what appears on the patient record and ultimately the Medical Records Management screen, the Episode Events control how and when messages appear on the Communications Worklist instead.

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Add Action

Click on the Add Action to create a new event.  A large Event Setup window will appear.

Due to the length of this window, discussion will be broken up into two sections.

Event, Action, and Mail Settings

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The Event line allows you to choose which event will fire off a communication:  Patient check-in, admit, discharged, order closed, unit transfer, or document verification.  The Daily Update option is also available that entails a manual process on the Communication Worklist, to fire off a specific document or request to an RDVM or Client for inpatients who may not have other major activity for several days. 

The Action line indicates who should receive the communication:  The owner/client, or the referring RDVM and Clinic?  In both cases, the client must have the selected flag turned on under the Client Settings to receive the medical record communications.   Clients with the Do Not Communicate flag turned on will receive nothing.

Auto Send will automatically send this once a document or request has been verified.  Always Send will fire off the communication, even if the document or request has not yet been added to the patient record.  (This may be useful for certain communications that can be done entirely in the Email Body using placeholders.)  Send if Deceased will send the communication even if the patient has a deceased date - this may be recommended for RDVM communications for final discharge updates. 

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The Mail Settings store the generic information that will be sent as an email or fax.  These fields support placeholders which will also pull in the appropriate information directly from the patient or client records, allowing you to personalize the communication appropriately.

Documents and Reports Settings

The bottom half of this screen is where you can selected a Document or Request Report to attach to the communication.  You can select an entire medical record group, such that any document or request added to that group on the episode will be included, or you can select a specific report, document, or request catalog item to include as long as it is present on the patient record.

Individual Document / Request is only available under the Event type of Document Verification. 

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Add Record Group

Click on the Add Record Group button to add a new medical record category to the Event.

Select the Record group you want to add, and choose the rules: Optional (will send whether this is included or not) or Required (will only send when this item is added.)   You can also select a specific status.  VetView recommends not sending until the contents of a medical record group are Completed, but for certain lab requests you may wish to include Preliminary statuses as well.

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Add Report

This option allows you to select a custom local report to add.  System reports are handled under the Individual Document / Request section instead.

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Add Individual Document / Request

When the selected Event is Document Verification, you can specify which document or request has to be verified before it is sent. 

Select the Unit, the Catalog, and the specific Catalog Item.

If a document is changed and the status becomes Reverified or Addended, you can also choose to resend the new results.  This may be especially useful for labwork.

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Edit Action

To change an existing event, click on the line you want to modify and press Edit Action.  The large Event window will open for you to make the necessary changes.  

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Delete Action

Episode Events occur in real time.  Events can safely be deleted without impacting historical data.  Any previously sent communications will still appear in the Comm Worklist and on the patient's Communication Log. 

Select the row you want to delete, and click on the Delete Action button.

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Setup & Admin Guides
Setup & Admin Guides
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