Care plans

Prepare and activate a care plan, give the patient their copy, run reviews, and pause or close the plan.

A care plan holds the goals, interventions and review points you agreed with a patient. A draft only keeps your preparation. Activating it starts the scheduled work. Changing a plan needs Write all clinical records, or Write assigned clinical records together with a link to the patient (assigned doctor, plan creator or responsible team member).

Prepare a draft

Open the patient and choose New → Care plan, or New care plan on the Care plans page. A draft opens.
Give it a title and write the Background: why this plan, and why now.
Add Goals. Choose whether each is measured, with a vital or a custom number, or judged at review. For measured goals, On a schedule adds recurring check-ins and At review only does not.
Add Interventions, such as a medication, exercise, form or team task, with their schedules.
Add at least one review point. Set the start date, duration and timezone, and the For the patient section with when to call.

The draft saves as you type. The Agent can draft a plan from your instructions. Review its text and rows separately, because you are responsible for the plan's content. Discard draft deletes a draft permanently.

Activate the plan

Activate… stays disabled until the plan has background text, a goal, an intervention, a review point, a workable schedule, a start date, a timezone and a duration. It also needs a patient email address when the plan emails the patient, and a patient with no active duplicate of a medication the plan starts.

Choose Activate…. The screen shows what activation will start, week by week.
Check dates, recipients and review points.
Choose Activate plan.

Activating starts scheduled work. Patient check-ins go out by email from the first scheduled day, and team tasks and reviews appear on their dates. You can pause a running plan or cancel it, but you cannot take back what has already been sent.

An active plan and a delivered email are different results. Check the actual request status in the plan.

Give the patient their copy

Medicines and activities reach the patient on paper only. Check-in emails ask for readings or answers. They do not carry the plan.

After activating, choose Print patient copy. Choose it again whenever the plan changes.
Give the printed plan to the patient.
Choose Handed over to record that they have it.

Until you do this, the patient has not received the plan's medicines and activities. When you change the plan after printing, the plan shows the copy as out of date and offers Print new copy. Handed over records that you gave the paper to the patient. It sends nothing.

Follow the plan and run reviews

Week board and the timeline show what is due. The Needs you band lists overdue tasks, unanswered check-ins, a printed copy that needs attention, and email problems. For an email problem choose Fix email or Switch to paper. A goal shows its last value and target. Choose Request check-in on a goal to email the patient a one-time link. Sending reaches the patient.

When a review is due, choose Start review, write the note, then Complete review. An interim review ends as on track, adjust or off track. Saving the note alone does not complete the review. Read the measurements before you choose, because a missing answer is not a clinical verdict.

Pause, complete or cancel

Use More actions in the plan.

Pause… needs a reason and can hold a planned resume date. Scheduled tasks and patient emails are suspended. Resume… shows which items shift and the new end date before you confirm.
Complete… asks for a verdict on every goal (Achieved, Partially or Not achieved) and which standing orders continue. Confirm with Complete & sign. Future scheduled items are cancelled.
Cancel… needs a reason and lets you keep chosen orders as standalone orders. It stops all scheduled work.

Cancelling cannot be undone. Use Pause… if the plan might continue.

On a completed plan, Renew… creates a new draft to review before you activate it.