When a patient is loaded into the Clinigence system the patient is assigned to the practice and based on the configured rules to one or more providers. Each provider who is active in the practice should have patients assigned to him/her. Only the patients assigned to the provider and who meet the other measure criteria appear on the Measure Detail patient lists for that provider.
Note: If there are no patients assigned to a provider, Clinigence cannot calculate reports for that user and the provider name will not appear as an active (clickable) link.
The Patient/Provider Assignment logic uses two different methods for finding relationships between patients and providers:
- Explicit Assignments
- Encounter Assignments
Each of these events can establish a relationship between the patient and the provider and mark the beginning of the relationship.
Ending the Relationship
The Patient/Provider relationship will be given an end date by one of three methods:
- Mutual Exclusivity
The Electronic Health Record can usually explicitly assign patients to providers. When such a relationship is identified, then the patient is assigned to that provider and the property date is treated as the date on which the patient/provider assignment began.
Explicit assignments are turned on by default.
Encounter Assignments are usually used in practice which sees patients in a clinic setting, that is that the patient sees whichever provider is available when they come into the practice. Encounter Assignments will assign a patient to a provider when all of the following conditions are met:
- Encounter Assignments are enabled for the practice.
- The provider is either an active practice member or an explicit assignment has been made to that provider.
- An encounter is recorded with the provider specified as the performer/owner.
- The encounter maps to a specified code list (The Encounter code list can be controlled by the practice.)
Encounter assignments are not turned on by default but can be requested at the time the site setup is requested.
When Mutual Exclusivity is turned on, then an event which establishes a relationship between the patient and a provider will cause the simultaneous ending of a prior relationship with a different provider. When this is turned on, the patient will only show up in one provider's list. This is generally not used in combination with Encounter Based assignments as the patient will move from provider to provider depending on who they last saw.
Mutual Exclusivity is turned off by default.
When Expiration is turned on, then an event which establishes a relationship between the patient and a provider will automatically expire at the end of a specified period of time unless another event is recorded.
Expiration is set by default to 2 Years.
Explicitly Ending the Relationship
The Electronic Health Record can explicitly record the ending of a patient/provider relationship. When such a property is reported then the property date is treated as the date on which the patient/provider assignment ended.