The Longitudinal Patient Journey & Care Continuum

MOANA EHR orchestrates the entire patient journey across all hospital departments into a single, continuous, auditable clinical record.

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1. End-to-End Clinical Care Continuum

graph LR
    A[1. Patient Registration & MPI] --> B[2. Triage & Consultation]
    B --> C[3. Clinical Orders: Rx, Lab, Imaging]
    C --> D[4. Diagnostic Results & Pharmacy]
    D --> E[5. Inpatient Care & eMAR]
    E --> F[6. Discharge & Billing Settlement]

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2. Complete Patient Journey & Automatic Handoffs

Information flows automatically between healthcare roles at each handoff point — reducing errors and ensuring that the right person has the right information at the right time.

Stage	Responsible Role	What Happens in Moana	Automatic Handoff To
01 Patient arrives	Receptionist	MPI search → registration → encounter opened → patient queued	Doctor's clinical queue
02 OPD / Emergency	Receptionist, Nurse	Encounter opened; triage vitals entered; acuity set; doctor assigned	Doctor + nursing care team
03 Consultation	Doctor	Patient banner confirmed; allergies reviewed; SOAP note; ICD-10 diagnosis	Order-receiving teams
04 Orders placed	Doctor	Lab orders → LIS; Imaging orders → Radiology worklist; Prescriptions → Pharmacy queue	Laboratory, Radiology, Pharmacy
05 Laboratory	Lab Technician, Supervisor	Order received in LIS; specimen processed; result entered; Supervisor verifies; Dispatch releases to doctor	Doctor's results view
06 Radiology	Radiologist	Order received; study performed; DICOM uploaded to PACS; reviewed in OHIF; report written and released	Doctor acknowledges
07 Pharmacy	Pharmacist	Prescription verified; drug-allergy and interaction checked; prepared; final check (four-eyes); dispensed	Nursing MAR (eMAR)
08 Inpatient	Doctor, Nurse, Administrator	Admission recorded; bed allocated; source encounter closed; nursing dashboard updated; daily ward visit task created	Inpatient nursing care team
09 Nursing care	Nurse	Vitals recorded; NEWS2 score calculated; tasks completed; medications administered against MAR; handover submitted	Doctor (for clinical escalations)
10 Discharge	Doctor, Nurse, Receptionist	All results reviewed; discharge summary completed; medication reconciliation; bed released; billing flagged	Billing & Finance
11 Follow-up	Doctor, Receptionist	Follow-up appointment booked; longitudinal record updated; referrals documented	Patient longitudinal record

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3. The "One Encounter at a Time" Safety Rule

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IMPORTANT:

One Encounter at a Time Rule The system strictly enforces that a patient can only be active in one of Outpatient (OPD), Emergency (ED), or Inpatient at any given time. Attempting to open a second active encounter raises a conflict. If you see this error, check whether the patient has an existing open encounter in another department before proceeding.

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4. Transition Protocols Between Care Settings

• OPD to Inpatient (IPD): Attending doctor submits an admission order. The patient routes to the Bed Command Center queue where the ward nurse assigns an available bed.
• Emergency (ED) to Operating Theatre (OT): Emergency trauma surgeon flags an emergency theatre booking. The patient bypasses general holding and routes to the emergency surgical suite.
• Inpatient Ward to Ward Transfer: Requesting ward submits a transfer request via the Ward Transfer Dialog. The receiving ward allocates a target bed, simultaneously releasing the source bed into housekeeping decontamination status.
• Clinical Discharge to Outpatient Follow-Up: Discharge summary automatically generates an outpatient clinic booking and routes take-home prescriptions to the dispensary.