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04-30-2026 11:35 AM
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What this ontology represents
Patient Care Journey describes what happens during a hospital visit. It includes the people (Patient, Doctor), the visit itself, the medical decisions made (Diagnosis, LabTest, Prescription), and the paperwork that follows (Appointment, Bill, Insurance). Together, these nine entities and the twelve relationships between them form a complete picture of a single episode of care.
The real-world scenario it models
A hospital is really doing two jobs at the same time. It is treating the patient medically — figuring out what's wrong, running tests, prescribing treatment. And it is processing the patient administratively — scheduling, billing, claiming insurance. Most of us experience these as one continuous event, but inside the hospital they are run by separate teams using separate systems. This ontology shows how those two flows connect through a single shared moment i.e. the Visit.
Why these entities and relationships matter
Each connection in this model reflects how things actually work in a hospital.
A LabTest supports a Diagnosis. One test can help confirm several conditions, and most diagnoses are based on more than one test.
A Bill is claimed against an Insurance policy, not the other way around — because that is how reimbursement actually flows.
An Appointment results in a Visit. The scheduled time becomes real care.
These choices make the model easy for a human to read and useful for an AI to reason over. It can tell a medical question apart from a billing question, even when both are about the same patient.