The ADMISSION OBJECT represents a CASE (patient) that is inscribed in the system to follow the protocols defined in a PROGRAM and that will be managed by a specific TEAM of professionals.

Note that the same patient can have different ADMISSIONS because it means that he is following different PROGRAMS (e.g a post-surgery rehabilitation program and at the same time a Pain relief program), which can be also be managed by different TEAMS of professionals.

The combination of a PROGRAM being managed by a TEAM is materialized by the https://linkcare.atlassian.net/wiki/spaces/WS/pages/21200903. So, when an ADMISSION is created, it is not directly associated with a PROGRAM, but instead it is associated with the https://linkcare.atlassian.net/wiki/spaces/WS/pages/21200903 that represents the desired PROGRAM managed by an specific TEAM.

ADMISSIONS and PROGRAM VERSIONS

As mentioned, an ADMISSION is created for a CASE to execute the TASKS defined in some PROGRAM, but a PROGRAM may have several versions. It is even possible that a new version of the PROGRAM is published during the lifetime of an ADMISSION, but we don’t want any change to interfere in the normal operation of the patients. To avoid problems derived from the implementation of new versions of a PROGRAM, the platform works as follows:

When a new patient is enrolled (using certain SUBSCRIPTION), then an ADMISSION object is created and assigned with the PROGRAM and version of the related SUBSCRIPTION (see the https://linkcare.atlassian.net/wiki/spaces/WS/pages/21200903 for additional details)
Any existing ADMISSION will always use the PROGRAM and version that was assigned at the moment of its creation. This means that even if the SUBSCRIPTION is modified to use a newer version, the existing ADMISSIONS will not be affected by this change. The only way to modify the version assigned to an ADMISSION is by explicitly requesting it (using the API function https://linkcare.atlassian.net/wiki/spaces/WS/pages/3350560785)

ADMISSION PROPERTIES

PROPERTY	TYPE	DESCRIPTION	COMMENTS

PROPERTY	TYPE	DESCRIPTION	COMMENTS
REF	String	Reference to the ID and the center of the admission.
VERSION	String	Last version of the program when admission was created or updated
CASE	String	Related case to the admission.
PROGRAM	PROGRAM VERSION OBJECT	PROGRAM VERSION that the patient of this ADMISSION is following	Includes de code tag ( PROG_CODE)
SUBSCRIPTION	https://linkcare.atlassian.net/wiki/spaces/WS/pages/21200903	Represents the combination of PROGRAM + TEAM (Owner of the SUBSCRIPTION) to which this ADMISSION belongs
ENROL_DATE		Date of enrollment of the patient (date of creation of the ADMISSION)
ACCEPTED	String	Indicates whether the PATIENT related with this ADMISSION has all the necessary personal data required by the PROGRAM. When there is personal data missing, the patient cannot start following the PROGRAM until that data is provided. Meanwhile, the ADMISSION will remain with status “INCOMPLETE” (see ADMISSION STATUS) Possible values: 'T': Patient data is complete 'I': Patient data is incomplete	The personal data required to allow a patient to be enrolled in an ADMISSION is defined by means of the https://linkcare.atlassian.net/wiki/spaces/WS/pages/41517285
ADMISSION_DATE	Date	Date when the ADMISSION passes from status “ENROLL” to “ACTIVE” (see ADMISSION STATUS)
DISCHARGE_REQUESTDATE	Date	Date when the discharge of the ADMISSION has been requested (but not necessarily discharged)
DISCHARGE_DATE	Date	Date of discharge of the ADMISSION (see ADMISSION STATUS)
DISCHARGE_TYE	DISCHARGE TYPE	Reason of the discharge of the ADMISSION
SUSPENDED_DATE	Date	Date when the ADMISSION was suspended (see ADMISSION STATUS) Normally an ADMISSION is suspended when the patient cannot follow the PROGRAM temporarily
REJECTED_DATE	Date	Date of rejection of the ADMISSION. During the evolution of the PROGRAM it is possible to decide that it makes no sense for the patient to continue with the PROGRAM.
NOTES	String
STATUS	ADMISSION:STATUS	Status of admission. The status of an ADMISSION changes during its life cycle, and each status change may involve different actions. See ADMISSION life cycle for more information.
HIS_EPISODE_REF	String	Reference to an episode in an external HIS that is related with this ADMISSION
TRIAL	Choice of ADMISSION:TRIAL	Arm of a trial program where patient joined
DELETED	#TRASH:ID	Key to relate the TASK deleted with the entry in TRASH table
ID_REFERRAL	https://linkcare.atlassian.net/wiki/spaces/WS/pages/20054305	PROFESSIONAL assigned as referral of the ADMISSION
ID_REFERRAL_TEAM	https://linkcare.atlassian.net/wiki/spaces/WS/pages/8913010	TEAM assigned as referral of the ADMISSION
REFERRAL_LOG	REFERRAL_LOG	History of PROFESSIONALS assigned as referrals of the ADMISSION
CREATION_MODE	String	Indicates the type of user that created the ADMISSION (a PROFESSIONAL, CASE or ASSOCIATE)
ADHERENCE	Int	Measure of the adherence of a patient to the ADMISSION. Must be a value in the range 0..6	All this fields are used to measure the performance of a patient in an ADMISSION. See ADMISSION Performance measure for more details
COMPLIANCE	Int	Measure of the compliance of a patient to the ADMISSION. Must be a value in the range 0..6
OUTPUT	Int	Measure of the output of the ADMISSION. Must be a value in the range 0..6
ADHERENCE_VALIDITY	Date	Date until which the measure of the adherence is valid
COMPLIANCE_VALIDITY	Date	Date until which the measure of the compliance is valid
OUTPUT_VALIDITY	Date	Date until which the measure of the output is valid
LIMIT_DATE	Date	Limit date for finishing the ADMISSION. If the date is reached and the ADMISSION has not been discharged, then it will be discharged automatically.	This date is related with the properties DURATION of a PROGRAM and/or SUBSCRIPTION. When an ADMISSION enters the “ENROLL” stage, the limit date is set to the current date + DURATION

ADMISSION STATUS PROPERTIES:

ADMISSION life cycle

When an ADMISSION is created, an initial status is assigned and it will change along the ADMISSION life cycle. The following diagram illustrates the possible flow of the ADMISSION status:

Status description

STATUS	VALUE (See ADMISSION.STATUS CODE)	DESCRIPTION

STATUS	VALUE (See ADMISSION.STATUS CODE)	DESCRIPTION
INCOMPLETE	0	This status is assigned to new ADMISSIONS that have been created without the minimum necessary information. It is not possible to change to status ENROLL before the information is completed
ENROLLED	5	This status is normally used for deciding the eligibility of a patient. In many cases a patient cannot not be accepted in a PROGRAM unless some conditions are met. For example, a PROGRAM to assess the risk of cancer of a patient based on his family antecedents does not make sense if the patient does not have any family member with cancer. In this case we can define a questionnaire in the ENROLL phase to determine the validity of the patient.
ACTIVE	1	An active admission. This is the normal status where a PROFESSIONAL and/or a CASE can execute the TASKs defined in the PROGRAM.
REJECTED	2	The ADMISSION has ended because it has been rejected
DISCHARGED	4	The ADMISSION has ended because it has been the patient has been discharged.
PAUSED	6	The ADMISSION is temporarily "on halt".

Task stages and Admission Status

When a PROGRAM is designed, each WORKPLAN OBJECT can be assigned to a particular STAGE, which has a direct relation with the ADMISSION status.

Whenever an ADMISSION changes its status, the system creates automatically a set of TASKS based on the WORKPLAN OBJECT assigned to the associated stage. For example, when an ADMISSION status changes from "ACTIVE" to "ENROLLED", then a new TASK will be created for each WORKPLAN OBJECT assigned to the "ENROLL" stage.

Status transitions

The transition of a status to the following one generally can occur automatically or forced manually as follows:

The first status of an ADMISSION is always set initially to INCOMPLETE when it is created. Nevertheless this status may change automatically if the condition explained in the next point happens.
Status is changed automatically by the platform in the following situations:
- Status = INCOMPLETE and the patient personal data is complete and there are no pending TASKs. The status is changed automatically to ENROLL
- Status = ENROLL and there are no pending TASKs. The status is changed automatically to ACTIVE
- Status = ENROLL and there is a condition that determines that the patient must be rejected (not accepted in the PROGRAM).The status is changed automatically to REJECTED
Status can be changed manually in the following situations
- Status = ENROLL. Can be changed manually (or by means of a FORMULA) to REJECTED
- Status = ACTIVE. Can be changed manually (or by means of a FORMULA) to REJECTED, DISCHARGED or PAUSED
- Status = PAUSED. Can be changed manually (or by means of a FORMULA) to ACTIVE

Whenever an ADMISSION reaches a new status, the PROGRAM TEMPLATE is examined to find out if there are specific TASKS designed for the stage that corresponds to the new ADMISSION status. If true, the TASKs will be added to the ADMISSION. Generally when all the TASKs are complete, the status transitions automatically to the next one (as explained before).

The status of an ADMISSION may change in the following circumstances:

When all the TASKs of an STAGE are completed. In this situation the ADMISSION status changes automatically to the status that corresponds to the new stage
When the user manually changes the status. This is permitted generally to CASE MANAGERs of the ADMISSION. The function action_list_user () can return the list of available actions (that can then be executed using action_exec ()).

When the status of an ADMISSION changes, some additional actions may be executed:

INITIAL STATUS	NEW STATUS	ACTIONS

INITIAL STATUS	NEW STATUS	ACTIONS
-	INCOMPLETE	This is the situation when a new ADMISSION is created. TASKs from stage "ADMSETUP" of the PROGRAM OBJECT are added to the ADMISSION. After inserting the TASKs, the system will try to close them immediately without waiting for any human interaction. If you don't want any of these TASKs to be closed automatically, then it is necessary to configure at least a "mandatory" ITEM, which prevents the closure until a value has been assigned. TASKs from stage "INCOMPLETE" of the PROGRAM OBJECT are added to the ADMISSION, but ONLY if the profile of the CASE is not complete according to the rules defined in the FORMAT SETTINGS of the SUBSCRIPTION.
INCOMPLETE	ENROLL	A SYSTEM TASK with TASK CODE "ENROLL" is inserted to keep track of the moment when the status was changed TASKs from stage "ENROLL" of the PROGRAM OBJECT are added to the ADMISSION
ENROLL	ACTIVE	A SYSTEM TASK with TASK CODE "JOIN" is inserted to keep track of the moment when the status was changed TASKs from stage "ENROLL" of the PROGRAM OBJECT are added to the ADMISSION
ACTIVE	PAUSE	A SYSTEM TASK with TASK CODE "PAUSE" is inserted to keep track of the moment when the status was changed All TASKs that have status "OPEN" are paused (changed to status "PAUSE")
ACTIVE, PAUSE	DISCHARGE	A SYSTEM TASK with TASK CODE "DISCHARGE" is inserted to keep track of the moment when the status was changed All TASKs that have status "OPEN" are canceled (changed to status "CANCELLED_BY_ADMISSION") All EVENTS that have status "OPEN" are closed and a comment is added explaining the reason TASKs from stage "ENROLL" of the PROGRAM OBJECT are added to the ADMISSION
ACTIVE, PAUSE	REJECT	A SYSTEM TASK with TASK CODE "REJECT" is inserted to keep track of the moment when the status was changed All TASKs that have status "OPEN" are canceled (changed to status "CANCELLED_BY_ADMISSION") All EVENTS that have status "OPEN" are closed and a comment is added explaining the reason TASKs from stage "REJECT" of the PROGRAM OBJECT are added to the ADMISSION
PAUSE	ACTIVE	A SYSTEM TASK with TASK CODE "RESUME" is inserted to keep track of the moment when the status was changed All TASKs that were paused when the ADMISSION entered in status "PAUSE" are restored to the status "OPEN"
PAUSE, DISCHARGE, REJECT	ACTIVE	A SYSTEM TASK with TASK CODE "RESUME" is inserted to keep track of the moment when the status was changed All TASKs that were cancelled when the ADMISSION entered in status "PAUSE", "DISCHARGE" or "REJECT" are restored to an open status

ADMISSION TRIAL Properties

PROPERTY		DESCRIPTION

PROPERTY		DESCRIPTION
TRIAL:INTERVENTION	Intervention	Specifies an admission to an intervention group.
TRIAL:CONTROL	Control	Specifies an admission to a control group.
TRIAL:NULL	Null	Neither intervention or control group specified.

Discharge types

When an ADMISSION is discharged, it is necessary to indicate the reason of the discharge

PROPERTY	DESCRIPTION

PROPERTY	DESCRIPTION
END	The patient completed the PROGRAM
EXITUS	The patient died during the evolution of the PROGRAM
DROPOUT	The patient left the PROGRAM without having ended it
MOVED	The patient has moved to another place and cannot continue with the PROGRAM
TRANSFER	The ADMISSION has been transferred to another SUBSCRIPTION

REFERRAL LOG Properties

Contains the history of PROFESSIONALS assigned as REFERRALS of an ADMISSION

PROPERTY	TYPE	DESCRIPTION

PROPERTY	TYPE	DESCRIPTION
ADMISSION:LOG:REF	ADMISSION	Reference to an ADMISSION
ADMISSION:LOG:PROFESSIONAL	PROFESSIONAL	PROFESSIONAL assigned as REFERRAL of the ADMISSION
ADMISSION:LOG:TEAM	TEAM	TEAM assigned as REFERRAL of the ADMISSION
ADMISSION:LOG:DATE	DATE	Date of assignment of the referral PROFESSIONAL

ADMISSION Performance measure

During the evolution of a patient in an ADMISSION, it is possible to assign some measures to evaluate how the patient is performing. Currently the ADMISSION supports the following 3 measures:

ADHERENCE: is a value to measure whether the patient is finishing the TASKS assigned to him according to the schedule
COMPLIANCE: is a value to measure whether the patient is obtaining the expected results
OUTCOME: Used to assign a final value or score to the ADMISSION

Currently the performance values are not calculated automatically by the platform. The PROGRAM should contain the logic to calculate the performance measures and assign them to the ADMISSION by means of the https://linkcare.atlassian.net/wiki/spaces/WS/pages/2240708609 formula.

The meaning of the values assigned to the performance measures is currently interpreted as follows:

0: No value assigned
1..6: Value indicating how good is the measure, being 1 the best value and 6 the worst.

ADMISSION WEB SERVICES

BROWSING ADMISSIONS:

WS	DESCRIPTION

WS	DESCRIPTION
admission_list_program ()	Searches for admissions in a program. It can be defined the scope of search (LOCAL, TEAM or AUDIT)
admission_list_protocol ()	Searches for admissions in a protocol of a program. It can be defined the scope of search (LOCAL or TEAM)
admission_list_case ()	Lists all the admissions of a case and the Health principal diagnose.
admission_enroll_list ()	Lists ENROLMENTS of admission in the programs where the active user or the active team have a case manager role.

CHANGING ADMISSIONS STATUS:

WS	DESCRIPTION

WS	DESCRIPTION
admission_discharge ()	Establishes the discharge of an admission in a date, including the notes about the discharge.
admission_reject ()	Establishes the admission status into “REJECTED” and reports the rejection_date.
admission_resume ()	Is a function to make the resume of an admission in a date.
admission_suspend ()	Suspends an admission and pauses all pending tasks.

ADMISSION FOLLOW UP:

WS	DESCRIPTION

WS	DESCRIPTION
admission_datacodes_list ()	Lists all data codes monitored in the admission.
admission_datacodes_report ()	Retrieves a report of the data code goals for the admission in .xls format

MANAGING ADMISSIONS:

WS	DESCRIPTION

WS	DESCRIPTION
admission_action_list ()	Returns a list of possible choices related with a task insertion.
admission_delete ()	Delete an existing admission into Internal Linkcare System.
admission_get ()	Retrieves all the information about an admission.
admission_create ()	Introduces a CASE intro a PROGRAM.
admission_join ()	Associates a previously enrolled admission into a protocol.
admission_set ()	Updates all the information of an existing ADMISSION.
admission_update ()	Updates an exist admission from current version to the version of subscription.
task_action_list ()	Returns a list of possible choices related with a task.
admission_referral_list ()	Returns a list of TEAMS/USERS that can act as referrals of an ADMISSION