Creating a New Patient Encounter

Okay, here is the documentation for creating a new patient encounter.

Creating a New Patient Encounter

This flow describes how a physician initiates and documents a patient encounter within the MedTrack platform.

1. Login: Access the MedTrack Physician Dashboard at https://physician.medtrack.io and log in using your credentials.
2. Find the Patient:
   • Navigate to the Patients section (https://physician.medtrack.io/patients) or the In Patients section (https://physician.medtrack.io/in-patients).
   • Use the search bar or browse the list to find the desired patient.
   • Click on the patient's name or record to open their detailed profile page (e.g., https://physician.medtrack.io/patients/[patientId]).
3. Start New Encounter:
   • On the patient's profile page, locate and click the Start Encounter button (or a similarly named button like "New Visit"). This will initiate a new encounter session for the patient. You will likely be redirected to the dedicated encounter page (e.g., https://physician.medtrack.io/patients/[patientId]/encounter/new).
4. Document the Encounter: Within the encounter interface (e.g., https://physician.medtrack.io/patients/[patientId]/encounter/new), you can add various clinical details. This typically involves separate sections or forms:
   • Record Vitals:
     • Click on "Add Vitals" or navigate to the Vitals section on the encounter page.
     • Enter the patient's Temperature, Blood Pressure (Systolic/Diastolic), Heart Rate, Respiratory Rate, SpO2, Weight, and Height. BMI may be calculated automatically.
     • Save the vitals information.
   • Add Consultation Notes:
     • Click on "Add Note" or navigate to the Consultation Notes section on the encounter page.
     • Document the Chief Complaint, History of Presenting Illness, Review of Systems, Past Medical/Surgical History, Allergies, Current Medications, Examination Findings, Diagnosis (using ICD-10 codes if applicable), and the Treatment Plan.
     • Save the consultation notes.
   • Create Prescriptions (if needed):
     • Navigate to the Prescriptions section on the encounter page and click "Add Prescription".
     • Search for the medication, specify dosage, frequency, duration, and any additional instructions.
     • Add the medication to the encounter's prescription list. Repeat for all prescribed medications.
   • Order Lab Tests (if needed):
     • Navigate to the Lab Orders section on the encounter page and click "Order Test".
     • Search for or select the required lab tests.
     • Add the tests to the encounter's lab order list.
   • (Optional) Add Billing/Service Codes: Depending on the workflow, there might be a section on the encounter page to add services rendered during the encounter for billing purposes.
5. Complete the Encounter:
   • Once all relevant information for the visit has been entered on the encounter page (e.g., https://physician.medtrack.io/patients/[patientId]/encounter/new), review the details.
   • Click the End Encounter, Complete Visit, or Save Encounter button to finalize and save the encounter record.
6. Confirmation/Error Handling:
   • Success: A confirmation message will indicate that the encounter has been successfully saved. The encounter details will be added to the patient's history, accessible via their profile page (https://physician.medtrack.io/patients/[patientId]).
   • Error: If any required fields within the forms (vitals, notes, etc.) on the encounter page are missed or invalid, error messages will guide you to correct the information before the encounter can be saved.