Patient Registration

[Bob Testa]

I am new to Cerner development but an old man in Healthcare systems.  I am attempting to develop a Stand Alone web application that will register the patient for a Lab or radiology encounter.  The idea is the patient can use the application to register prior to arriving at the facility or at a Kiosk located in the facility so that they can skip the registration manual process and report directly to the Draw station or radiology.  I don't clearly understand the relationship between the encounter and the registration process using the FHIR APIs.  Here are my steps:

1.  Patient Lookup

2.  Register for service

3.  Create the encounter.

The use case is a community provider hands the patient a paper order and the patient shows up at our facility.  This is not a scheduled procedure.

Thanks in advance for any help you can provide.

[Katey Kowal]

The relationship between encounter and registration is essentially one in the same. For a Cerner registration to occur, there must first be a created or existing person with required information populated (i.e. last/first name, DOB, Sex, Social, etc), and second there must be an encounter generated for that individual visit with required information populated (i.e. location, patient type, service type, registration date/time, physician information, etc). So in your 3 step outline, you can really eliminate step 2 as that occurs within step 3. One item to note is that a component of creating the encounter is adding in the necessary fields for billing such as insurance information (i.e. Guarantor/Subscriber/Health Plan info, etc). Some info may vary based on if it's a patient or client billing scenario, or if billing occurs outside of Cerner/3rd party Revenue system. 

The way it stands today there are some limited capabilities with creating an encounter via FHIR. While a shell of an encounter can be created and even sent with some of the pertinent information I outlined above, not all information can be sent and consumed into the database (you can review the encounter create specs here: Encounter | R4 API (cerner.com)). So while you may eliminate some work by having the patient do this ahead of time with an app or kiosk, it may only be a "partial" encounter that would still need to be updated by an end user with any relevant fields the API is not able to capture.