e eMRCarePatient-Centered Care Network

Clinic workflow guide

How a patient moves through the facility

This page describes the working day of a PhilHealth-accredited primary care facility running eMRCare: the path a patient takes from the gate to a closed record, who is responsible at each step, how Konsulta capitation is earned and tracked, and what your staff do when the internet is down.

Section 1

The patient journey

One visit is one encounter. It is opened at the front desk, passes through the hands that need it, and is closed once. Everyone downstream — pharmacy, laboratory, imaging — writes back into that same encounter, so nobody has to reconcile three separate pieces of paper at the end of the day.

The patient journey through a primary care facility A flowchart running top to bottom: arrival and identification, queue (with a cancelled or no-show exit), vitals, a decision on who sees the patient which branches to midwife consultation, teleconsultation or doctor consultation, then assessment, diagnosis and orders, which branches to pharmacy, laboratory and radiology, whose results return to the encounter before the encounter is closed. 1 · Arrival Find or register the patient. Confirm consent. Scan the QR card. 2 · Queue The encounter is opened and the patient takes a place in the queue. if they leave Cancelled or no-show Closed with the reason recorded. 3 · Vitals Height, weight, blood pressure and other readings recorded. Who sees the patient? routine or maternal medical case remote Midwife consultation Routine, maternal and newborn care. YAKAP empanelment and the First Patient Encounter form. Teleconsultation The same visit, held remotely. It writes into the same encounter as a walk-in would. Doctor consultation Examination and diagnosis, then prescribing and any laboratory or imaging orders. 4 · Assessment, diagnosis and orders Findings and diagnoses are recorded, then orders are raised for medicines, laboratory work or imaging as needed. 5a · Pharmacy The prescription is checked against allergies, interactions and stock, then dispensed from a tracked batch. 5b · Laboratory The order is accepted and results are entered on the structured Konsulta panel, or as a free-text order. 5c · Imaging The study is performed and the report recorded against the same visit, not a separate file. 6 · Results come back to the encounter Results, reports and dispensing records land on the same visit. A critical value raises an alert to the prescriber. 7 · Encounter closed The visit is completed and signed off. Every change in it sits in the audit log.
  • Front desk
  • Clinical
  • Diagnostic and dispensing
  • Decision
  • Optional or remote
Not every visit uses every stage. A patient collecting maintenance medicine may go from the queue straight to the doctor and then to the pharmacy; a well-child visit may never leave the midwife. The stages that are skipped are simply not recorded.

Section 2

Stage by stage

What actually happens at each desk, and what the system does about it.

Stage 1

Arrival and identification

The front desk searches the registry first and only creates a new record if the patient is genuinely new. Returning patients are pulled up by scanning their QR health card. Informed consent is captured here, and it can be revoked later — the record shows which is in force.

Stage 2

Queue

Opening the encounter puts the patient in the queue, where every station can see who is waiting and for what. If the patient leaves before being seen, the encounter is closed as cancelled or a no-show rather than left hanging.

Stage 3

Vitals

Readings are entered once and are visible to whoever sees the patient next. Nothing is copied from one form onto another.

Stage 4

Consultation

Midwives and doctors each have their own workstation showing their own queue. Midwife-led visits cover routine, maternal and newborn care and carry the YAKAP empanelment work, including the First Patient Encounter screening form set out in PhilHealth Circular 2024-0013, Annex G. Anything the midwife needs to escalate goes to the doctor on the same encounter. A teleconsultation writes into that same record.

Stage 5a

Prescribing and dispensing

Prescriptions are checked against the patient's allergies and against interactions between the drugs being prescribed. A prescriber who overrides a serious warning has to type a reason, and that reason is kept with the prescription. At the pharmacy counter the medicine is dispensed from a batch with its own expiry, so stock counts, low-stock warnings and expiry warnings stay honest.

Stage 5b

Laboratory

The Konsulta diagnostic panels are built in as structured forms — complete blood count, urinalysis, chest X-ray, sputum microscopy, lipid profile, fasting and random blood sugar, ECG, fecalysis, Pap smear, glucose tolerance, faecal occult blood, creatinine, PPD and HbA1c. Anything outside those panels is ordered as free text. Results keep the answer the laboratory actually gave: "trace" stays "trace", "+++" stays "+++". The panels and the Konsulta reference numbering are built and in use. In demo, the Konsulta report that carries them can be built, checked, sent and receipted against a local PhilHealth stand-in; live PhilHealth submission still needs the facility's credentials, code lists and published report structure.

Stage 5c

Imaging

Imaging is ordered from the consultation and the report is recorded against the same visit, so the doctor reading it is looking at the encounter that raised it.

Stages 6 and 7

Results and closing

Results and dispensing records return to the encounter. A critical laboratory value raises an alert to the prescriber rather than waiting to be noticed. When the visit is complete it is signed off and closed — and every access and change made along the way is already written to the audit log.

Two things that follow a closed encounter

Notifiable disease reporting. Where a case falls under RA 11332, the report is raised from the encounter. Immediately-notifiable diseases run against the 24-hour clock; the rest go out on the weekly export.

Claims, where the visit is claimable. Claim assembly, checking each claim against PhilHealth's own published claim grammar before anything leaves the facility, encrypted sending, attachment of supporting documents, checking the status of what was sent and reconciling the claim series all sit downstream of the encounter — handled by the records officer, not by the clinician. Capitated Konsulta patients do not travel this path; see the next section.

Section 3

How Konsulta capitation is earned

This is the part facilities most often get wrong, so it is worth being blunt about it: capitation is not claimed. There is no claim form per capitated patient and nothing goes through the claims path. PhilHealth pays for the member you have empanelled. The two acts that earn the money are the empanelment itself and the First Patient Encounter. Filing is not one of them.

The capitation sequence Four steps left to right: register the member, empanel the member, complete the First Patient Encounter, and tranche one is earned. Empanelment and the First Patient Encounter are marked as the two acts that earn payment. Below the fourth step, a dashed box shows that tranche two turns on year-end performance. These two acts earn the payment — filing does not STEP 1 Register The member is registered at the facility. STEP 2 Empanel Identity verified, consent given, member empanelled. STEP 3 First Patient Encounter The screening encounter is completed and recorded. RESULT Tranche 1 earned Earned once registration and the encounter are done. later Tranche 2 Turns on the facility's year-end performance. Nothing on this line is a claim. No claim form is filed per capitated member, and nothing here travels the claims path.
Payment arrives in tranches — the first tied to registration plus the First Patient Encounter, the second to the facility's year-end performance. The amounts, the split between tranches and the conditions attached to them are PhilHealth's to set and the facility's to enter. eMRCare supplies none of them.

What the capitation register shows you

The register exists to answer one question a municipal health officer actually asks: what have we earned, what has arrived, and what is holding up the rest?

Columns in the capitation register
What it showsWhy it matters
Members empanelled How many people the facility is being paid to look after this period.
First Patient Encounter completed How many of those members have had the encounter that completes the earning condition.
Still in progress Members part-way through — the working list for the week.
Expected against received, per tranche What the facility's own records say was earned, set against what has actually arrived.
Outstanding balance Earned but not yet received. This is the number to take into a follow-up.
One encounter away The ₱ amount the facility would earn by completing the First Patient Encounters that are missing — the single most useful figure on the page, because it is the cheapest money to collect.
Blocked members, with the reason Either "No First Patient Encounter recorded" or "Empanelment not completed". The encounter-only cases are listed first, because those are one visit away from being paid.

Three limits we would rather you heard from us

We do not tell you the rate. The facility enters its own per-member rate and cites the PhilHealth circular it came from. Those figures change, and they must come from the circular rather than from a software vendor. Nothing in eMRCare invents a peso figure or a tranche split.

The register does not transmit anything to PhilHealth. It is a register and a reconciliation tool. Payment advices are entered by hand and reconciled against what the clinic's own records say was earned, so a shortfall shows up as a number instead of a suspicion.

The YAKAP empanelment steps happen on PhilHealth's own systems. eMRCare records the outcome of each step as your staff complete it there — it does not perform the empanelment for you.

Section 4

Who does what

Ten staff roles, each with its own dashboard showing only that role's work. A user only ever reaches the pages their role permits — the pharmacist does not land on the claims screen, and the front desk does not land on the prescribing screen. Where several facilities share the same system, none of them can see another's patients.

Role responsibilities across the patient journey
Role Responsible for Stage
Facility administrator Staff accounts and role assignment, the facility profile and which modules are switched on, the capitation register and the entry of payment advices, and the facility's reports. Sees the whole facility, and only that facility. Across all
Receptionist Registers and searches patients, issues and scans QR health cards, captures and revokes informed consent, opens the encounter, manages the queue and appointments, and closes out cancellations and no-shows. 1 – 2
Nurse Vitals and triage, moving urgent cases up the queue, nursing notes, support during the consultation, and follow-up of patients who need to come back. 3
Midwife Midwife-led consultations — routine, maternal and newborn care — plus the YAKAP empanelment steps and the First Patient Encounter screening form, and escalation to the doctor when a case needs it. 4
Physician Examination, diagnosis and the problem list; prescribing under allergy and interaction checking; laboratory and imaging orders; review of returned results; recording a reason whenever a serious warning is overridden; teleconsultations; and signing off the encounter. 4, 6 – 7
Pharmacist Reviews and dispenses prescriptions, keeps inventory by batch and expiry, runs stock counts, and acts on low-stock and expiry alerts before they become a stock-out. 5a
Laboratory technologist Accepts orders, records results on the structured Konsulta panels or as free text, releases them back to the encounter, and flags critical values so the prescriber is alerted. 5b
Radiologic technologist Accepts imaging orders, performs the study, and records the report against the encounter that raised it. 5c
Encoder / records officer Completes and corrects encounter records, assembles claims and validates them before anything is sent, attaches supporting documents, tracks claim status and reconciles the claim series, and prepares the field health service information system returns and claims summaries. After 7
Barangay health worker Community-based household surveys, registration and empanelment work carried out in the field on a mobile device, and passing broadcast advisories and follow-up reminders to residents. Before 1

Two roles that watch the rest

Notifiable disease reporting under RA 11332 and the personal data breach register under RA 10173 and NPC Circular 16-03 both sit with the facility administrator and the records officer. Each carries its own clock — 24 hours for immediately-notifiable diseases, 72 hours for a personal data breach notification — and the system counts down rather than leaving anyone to work the deadline out from the calendar.

Section 5

When the internet is down

Rural health units lose their line. It is not an exception to plan around — it is a Tuesday. The clinic keeps running, and the work goes out once the connection comes back.

Keeps working

The clinic day

Registration, the queue, vitals, midwife and doctor consultations, prescribing, dispensing and the entry of results all continue. Staff do not stop and they do not fall back to paper that somebody has to re-key on Thursday.

Keeps working

The safety checks

Allergy checking, drug-interaction checking and critical-value alerts are judged against the facility's own records, so they keep firing during an outage. The audit log keeps recording too.

Waits

Anything that needs PhilHealth

Claim submission, claim-status checks and the empanelment steps that happen on PhilHealth's systems need a live line. Staff can still assemble and validate claims during the outage — only the sending waits.

On reconnection

Nothing disappears quietly

Work done during the outage is held and queued. When the line returns, each queued item is either sent, or raised as a conflict for a person to decide, or deliberately discarded. There is no fourth option where it is silently dropped.

What to tell the staff

  1. Carry on. Work the queue exactly as normal. The encounter is being kept locally.
  2. Do not enter the same record twice. A second copy made "to be safe" is the one thing that turns a clean outage into an afternoon of reconciliation.
  3. Check the queue of pending work once the line returns. Most items go out on their own; the few raised as conflicts need a person to say which version is right.
  4. Watch the clocks. An outage does not pause the 24-hour notifiable disease deadline or the 72-hour breach notification deadline. If either is running, use the fastest line available — a mobile connection is enough to send.

Where the patient sits in all of this

Residents have their own mobile app for their records, their health card and advisories the facility broadcasts. It reflects what the facility has recorded — so an encounter entered during an outage appears to the patient once the facility is back online, not before.