Hi all, In Cerner Millennium, ENCOUNTER_NUMBER is a native field that is assigned upon registration to different visits. Those visits are broken down in different ways for different Cerner clients, but based on Jim's note below, our breakdown of what qualifies as a separate "encounter" is less granular than the Epic system. An example would be a pre-admit Cardiology encounter that gets modified upon the patient presentation to a true Clinic encounter or whatever relevant encounter type would apply, but that is a registration workflow decision and not a characteristic of the data model. Each clinical care Cerner encounter has its own billing tied to that same encounter, not separated out into a billing encounter.
Naturally, there is a 1:Many relationship of Patient:Encounters. For i2b2 purposes, every encounter in Millennium has an "encounter type" associated to it that we map into our visit type ontological terms in i2b2. There are three code set in Millennium that hold the reference data that informs registration of different encounter types, and those all get mapped to our Cerner EDW reference content, and then into the i2b2 ontology as visit details to tease them apart. For an example, I've included a smattering of these codes from CMH and their i2b2 visit details path. We, too, are planning on mapping these i2b2 encounter types to the central PCORI visit details ontology to comply with the CDM. Let me know if I can clarify further! Millennium Encounter Type Cerner EDW Map i2b2 Mapped Path Pre-Recurring Research/Grant Preadmit \i2b2\Visit Details\Other\Preadmit\ Recurring Cardiology Recurring \i2b2\Visit Details\Outpatient\Recurring\ Recurring OH Neonatal Recurring \i2b2\Visit Details\Outpatient\Recurring\ Pre-Recurring Care Plan Oversight Preadmit \i2b2\Visit Details\Other\Preadmit\ Inpatient Inpatient \i2b2\Visit Details\Inpatient\Inpatient\ Emergency Emergency \i2b2\Visit Details\Outpatient\Emergency\ Same Day Surgery Day Surgery \i2b2\Visit Details\Outpatient\Day Surgery\ Observation Observation \i2b2\Visit Details\Outpatient\Observation\ Recurring Recurring \i2b2\Visit Details\Outpatient\Recurring\ Outpatient Outpatient \i2b2\Visit Details\Outpatient\Outpatient\ Preadmit Preadmit \i2b2\Visit Details\Other\Preadmit\ Pre-Observation Observation \i2b2\Visit Details\Outpatient\Observation\ Pre-Clinic Preadmit \i2b2\Visit Details\Other\Preadmit\ Pre-Same Day Surgery Day Surgery \i2b2\Visit Details\Outpatient\Day Surgery\ Pre-Inpatient Inpatient \i2b2\Visit Details\Inpatient\Inpatient\ Clinic Clinic \i2b2\Visit Details\Outpatient\Clinic\ Recurring Dialysis Recurring \i2b2\Visit Details\Outpatient\Recurring\ Pre-Recurring Burn Unit Preadmit \i2b2\Visit Details\Other\Preadmit\ Home Health Home Health \i2b2\Visit Details\Other\Home Health\ Pre Emergency Emergency \i2b2\Visit Details\Outpatient\Emergency\ Nate Apathy Program Manager, Cerner Research From: [email protected] [mailto:[email protected]] On Behalf Of Campbell, James R Sent: Friday, August 15, 2014 9:34 AM To: Fuehrer, Jay T; [email protected] Cc: Larose, Eric R Subject: RE: Encounter_num Jay At Nebraska we have rolled out our Epic encounter data and have created mapping to the PCORI valueset for encounter types. Epic has provided an unfortunate excess of encounters such that administrative, billing and non-patient care events are all assigned as encounters. Segregating between ED and hospitalizations as well as ambulatory surgery is a bit convoluted but we have sorted out the Clarity data structures necessary to do so. At this time we are planning to map the PCORI valueset data to a metadata element specifically for PCORI queries PCORI\Encounters\Encounter type When we have a LOINC code assigned from Regenstrief, we will add the LOINC basecode In some respects it would be cleaner to use LOS coding to identify service events but then non-billable patient care encounters would be ignored. Nate Apathy - how does Cerner record pateitn care encounters? Jim From: [email protected]<mailto:[email protected]> [mailto:[email protected]] On Behalf Of Fuehrer, Jay T Sent: Thursday, August 14, 2014 2:52 PM To: [email protected]<mailto:[email protected]> Cc: Larose, Eric R Subject: Encounter_num Just hopefully a quick question to the group. How are everyone's encounter_num field being defined(or filled in) in the observation fact table? From my understanding, those that have EPIC this is already sort of defined in the source data (I think), correct? At Marshfield, unfortunately we don't have anything like that in our source data. In the past, we have created encounter numbers for our VDW as part of the HMORN, and we have based it off of other information that we have such as MHN, date, provider, facility, etc. I'm just curious how this is defined for EPIC sites and for non-EPIC sites. Also, related to my question above, regarding the annotated data dictionary that we need to fill out - in particular the encounter type (which is part of the encounter, diagnosis, and procedure content areas). Are other sites currently loading these encounter types(AV, ED, IP, etc.) into i2b2? If so, what fields are they being stored in? Any info would be greatly appreciated here at Marshfield. Thanks much, Jay Jay Fuehrer Programmer/Analyst - Analytics & Data Management Biomedical Informatics Research Center - Marshfield Clinic Research Foundation (715)-221-6442 ________________________________ The contents of this message may contain private, protected and/or privileged information. If you received this message in error, you should destroy the e-mail message and any attachments or copies, and you are prohibited from retaining, distributing, disclosing or using any information contained within. 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