DOC - Clinical Encounter

Naming and Coding

Each medical visit is a markdown file named using the code format encXYZ-K-N.encounter, where XYZ is the patient's numeric identifier, K is the clinical case number, and N is the sequential number for the current visit. For example, enc100-1-2.encounter is the second visit of the patient with the aliasNIKOLAOS_PAPADOPOULOS_6945678901, related to the first clinical case.

If you click the pages icon at the top right of the title bar (see Fig. 1) above the banner, it will show the visit file under the patient’s folder within Windows System Explorer. Slightly to the left, there is another icon 📄; clicking this the file will appear in the left panel within Obsidian File Explorer.

Encounter/Visit Description

At the top of the visit page, Fig. 1, there are buttons that provide quick access to the patient's profile, history, medication, and medical library. Under these buttons there is the patient’s full name and age, the visit status (scheduled, in progress, completed, canceled, etc.), an internal link to the clinical case associated with the visit, and another link to the patient record summary. Just below the appointment date for the visit, also an internal link, is displayed. When you click the link it opens the appointment page (see appointment scheduling).

Fig. 1: The patient's second visit related to his first clinical case.
Fig. 1: The patient's second visit related to his first clinical case.

Content of Encounter

The visit is divided into the following sections. By clicking the corresponding link, you will be taken directly to the specific part of the patient's visit (see use of internal links):

Folding Sections/Text

Obsidian also provides the ability to fold and unfold text (folding). There are two buttons for this function above the banner image (Fold headings and list, Unfold headings and list). After folding, you can open just one section of the medical visit, e.g. General Review, to display the relevant information (Fig. 2).

Fig. 2: Folding all sections of the medical visit except for `General Review`
Fig. 2: Folding all sections of the medical visit except for General Review

Embedding a Section of the Visit

Thanks to the embedding capability that Obsidian provides, we can, embed the patient's Review of Systems (ROS) directly at this point:

New Encounter

To create a new visit for the patient NICKOLAOS_PAPADOPOYLOS_6945678901, open patient record summary and click the NEW VISIT button, as shown in Fig. 3. The new visit is automatically linked to the current (latest) clinical case of the patient.

Fig. 3: **The patient record summary** includes buttons for creating a **new clinical case** and a **new visit**. These buttons provide quick access for adding and linking new medical entries to the patient's record.
Fig. 3: The patient record summary includes buttons for creating a new clinical case and a new visit. These buttons provide quick access for adding and linking new medical entries to the patient's record.

Scheduling an Appointment with Obsidian Calendar Plugin

Before we begin filling out the details of the new visit, Obsidian MEDILIG will first create a new appointment for the patient. This appointment is automatically named using a standardized format that includes:

  • The date in the format YYYY-MM-DD,
  • The alias of the patient (full name and phone number),
  • And a number at the end indicating the total number of appointments-visits the patient has had.

For example, in the left panel of the interface, the entry 2024-08-23 NICKOLAOS_PAPADOPOYLOS_6945678901 (3) indicates the third appointment for this patient, which is also visible in the center of the screenshot (see Fig. 4).

These appointment files are stored separately from the patient’s folder, specifically under Calendar\Consultation, to ensure compatibility with the Calendar plugin. This setup allows the calendar to properly display appointments by month, week, day, or in a list view. In the example, we can see the appointment appearing as a yellow box on the selected day and time, indicating its scheduled placement on the calendar (Fig. 4).

Fig. 4: The patient's appointment, with its content displayed in the center, left panel displays file in the Obsidian File Explorer under Calendar-Consultation folder, right panel displays a yellow box on the calendar. This dual view allows for both detailed access to appointment notes and a quick visual reference of the patient's schedule within the overall weekly planning.
Fig. 4: The patient's appointment, with its content displayed in the center, left panel displays file in the Obsidian File Explorer under Calendar-Consultation folder, right panel displays a yellow box on the calendar. This dual view allows for both detailed access to appointment notes and a quick visual reference of the patient's schedule within the overall weekly planning.

Rescheduling the Appointment in the Calendar

To change the date and time of a patient’s appointment, the right-hand panel must be opened and the 📅 icon selected in order to display the full calendar. From this view, it is possible to choose how appointments are displayed (by month, week, day, or in list format). Then, click on the appointment box that requires modification. A black window will appear showing the appointment details, Fig. 5. After adjusting the date and time, the Save Event button must be pressed. The Open Note button provides access to the appointment contents (in the figure, it is already open).

Do not modify the appointment in any other way, and do not alter its contents.

Rescheduling of the appointment must be carried out only in the manner described above. Otherwise, problems may arise, such as the loss of the link between the visit and the appointment, or the appointment may fail to appear in the calendar.

Fig. 5: Changing the appointment date and time from the calendar. Here we can see the appointments for the day, 3 February 2024.
Fig. 5: Changing the appointment date and time from the calendar. Here we can see the appointments for the day, 3 February 2024.

The Scheduled Appointment and the front-matter

Information (data) such as the appointment’s date, start time, and end time is automatically recorded in the fields of the front matter, which can be accessed from the right-hand panel of the application (Fig. 6) by clicking the 🛈 icon.

Fig. 6: The content for the patient’s third (3rd) appointment and, in the right-hand panel, the front matter data describing the appointment. We can also see the field that links the appointment to the visit (`encounter_link`).
Fig. 6: The content for the patient’s third (3rd) appointment and, in the right-hand panel, the front matter data describing the appointment. We can also see the field that links the appointment to the visit (encounter_link).

Patient's New Visit

Αφού προγραμματίσουμε το ραντεβού μπορούμε να πατήσουμε τον εσωτερικό σύνδεσμο enc100-2-3.encounter όπως φαίνεται στην Fig. 6 για να ανοίξει η καρτέλα με την νέα επίσκεψη του ασθενούς (Fig. 7). Ακόμη η πρόσβαση στην νέα, πιο πρόσφατη, επίσκεψη του ασθενούς μπορεί να γίνει και από την σύνοψη του φακέλου ασθενούς στο τελευταίο τμήμα του που αφορά όλες τις επισκέψεις για όλα τα περιστατικά:

Once the appointment has been scheduled, the internal link enc100-2-3.encounter can be selected, as shown in Fig. 6, to open the record of the patient’s new visit (Fig. 7). Access to the patient’s new, most recent visit can also be made through the patient record summary, in the final section that lists all clinical encounters for all cases.

Or, if the case linked to the patient’s visit is already open, access can be made from the corresponding section, which displays only the visits for that specific case.

Fig. 7: The patient’s new visit for Friday, 23 August 2024, at 11:30 a.m.
Fig. 7: The patient’s new visit for Friday, 23 August 2024, at 11:30 a.m.

Front-Matter Data for the Visit (Encounter)

The information (data) entered in the fields of the medical visit record is automatically recorded in the fields of the front matter, which can be accessed from the right-hand panel of the application (Fig. 8) by clicking the 🛈 icon.

Fig. 8: The front matter fields with their different data types (text, date/time, boolean, numerical, object) and the corresponding values they take to describe the patient’s medical visit.
Fig. 8: The front matter fields with their different data types (text, date/time, boolean, numerical, object) and the corresponding values they take to describe the patient’s medical visit.

Scheduled appointments for the current week of the year.

From the physician page you have access to the appointments for the current week of the year..

Fig. 9: On the left, the doctor’s record and the table of scheduled appointments for the current week of the year. In Obsidian MEDILIG right-hand panel, the calendar has been opened, with the weekly view selected, to display the appointments.
Fig. 9: On the left, the doctor’s record and the table of scheduled appointments for the current week of the year. In Obsidian MEDILIG right-hand panel, the calendar has been opened, with the weekly view selected, to display the appointments.