Treatment Plans Skill

Generate professional medical treatment plans with SMART goal frameworks, evidence-based interventions, regulatory compliance, and validation tools for patient-centered care planning.

Overview

This skill enables clinical AI agents to create structured treatment plans that follow professional healthcare documentation standards. All plans include:

• SMART Goals - Specific, Measurable, Achievable, Relevant, Time-bound objectives
• Evidence-Based Interventions - Treatments aligned with current clinical guidelines
• Regulatory Compliance - HIPAA-compliant documentation with proper de-identification
• ICD-10 Coding - Appropriate diagnosis coding and severity classification

Treatment Plan Types

1. General Medical Treatment Plan

For primary care conditions including diabetes, hypertension, heart failure, COPD, and chronic kidney disease.

Key Components:

• Primary diagnosis with ICD-10 code
• Medication management with dosing schedules
• Lifestyle modification recommendations
• Follow-up schedule and monitoring parameters

2. Rehabilitation Treatment Plan

For physical therapy, occupational therapy, cardiac rehabilitation, and pulmonary rehabilitation.

Key Components:

• Functional assessment baseline (FIM scores, ROM, strength)
• Therapy goals with measurable outcomes
• Treatment frequency and duration
• Home exercise program

3. Mental Health Treatment Plan

For psychiatric care including depression, anxiety, PTSD, and substance use disorders.

Key Components:

• Standardized assessment scores (PHQ-9, GAD-7)
• Psychotherapy modality specification
• Medication management
• Safety planning and crisis contacts

4. Chronic Disease Management Plan

For complex multimorbidity and long-term care coordination.

Key Components:

• Comorbidity management matrix
• Care team coordination
• Annual review schedule
• Self-management education

5. Perioperative Care Plan

For preoperative optimization, ERAS protocols, and postoperative recovery.

Key Components:

• Preoperative optimization checklist
• ERAS protocol adherence
• Postoperative milestone tracking
• Pain management protocol

6. Pain Management Plan

For acute and chronic pain with multimodal analgesia and opioid-sparing strategies.

Key Components:

• Pain assessment tools
• Multimodal treatment approach
• Functional goals
• Risk mitigation for opioid use

SMART Goal Framework

All treatment goals must meet SMART criteria:

| Criterion | Definition | Example | |-----------|------------|---------| | Specific | Clear, well-defined outcome | "Reduce HbA1c" not "control diabetes" | | Measurable | Quantifiable metric | "HbA1c < 7%" not "better control" | | Achievable | Realistic for patient | Consider comorbidities and resources | | Relevant | Aligned with patient values | Patient-centered priorities | | Time-bound | Specific timeframe | "within 3 months" |

Example SMART Goals

Good:

• Reduce HbA1c from 8.5% to <7% within 3 months
• Walk independently 150 feet with assistive device by 8 weeks
• Decrease PHQ-9 score from 18 to <10 in 8 weeks
• Reduce pain from 7/10 to ≤4/10 within 6 weeks

Poor:

• "Feel better" (not specific or measurable)
• "Improve diabetes" (not specific or time-bound)
• "Get stronger" (not measurable)

Usage Instructions

1. Gather Patient Information

Before generating a treatment plan, collect:

• Chief complaint and history of present illness
• Past medical history and current medications
• Allergies and contraindications
• Functional status baseline
• Patient preferences and goals

2. Select Appropriate Plan Type

Choose the treatment plan type based on:

• Primary condition being managed
• Care setting (outpatient, inpatient, rehabilitation)
• Treatment phase (acute, maintenance, recovery)

3. Generate Plan Structure

The agent will create a plan with these sections:

1. Patient Information (de-identified)
2. Diagnosis and Assessment Summary
3. Treatment Goals (SMART format)
4. Interventions (pharmacological and non-pharmacological)
5. Timeline and Schedule
6. Monitoring Parameters
7. Expected Outcomes
8. Follow-up Plan
9. Patient Education
10. Risk Mitigation

4. Validate Compliance

Before finalizing, verify:

• [ ] All HIPAA identifiers removed
• [ ] ICD-10 codes accurate
• [ ] Medications include dose, route, frequency
• [ ] Goals meet SMART criteria
• [ ] Monitoring schedule defined
• [ ] Safety considerations addressed

Clinical Guidelines Alignment

Treatment plans should align with evidence-based guidelines:

General Medicine

• American Diabetes Association (ADA) Standards of Care
• ACC/AHA Cardiovascular Guidelines
• GOLD COPD Guidelines
• JNC-8 Hypertension Guidelines

Mental Health

• APA Practice Guidelines
• VA/DoD Clinical Practice Guidelines
• Evidence-based psychotherapy protocols (CBT, DBT, ACT)

Pain Management

• CDC Opioid Prescribing Guidelines
• WHO Analgesic Ladder
• Multimodal Analgesia Best Practices

HIPAA Compliance

All treatment plans must use HIPAA Safe Harbor de-identification:

Remove these 18 identifiers:

1. Names
2. Geographic data smaller than state
3. Dates (except year) related to individual
4. Phone numbers
5. Fax numbers
6. Email addresses
7. Social Security numbers
8. Medical record numbers
9. Health plan beneficiary numbers
10. Account numbers
11. Certificate/license numbers
12. Vehicle identifiers
13. Device identifiers
14. Web URLs
15. IP addresses
16. Biometric identifiers
17. Full-face photographs
18. Unique identifying numbers

Use age ranges instead of exact ages (e.g., "60-65" not "63")

Integration with TherapyPod

This skill integrates with:

• Medical Safety Engine - Validates emergency detection in plan content
• Triage System - Ensures appropriate severity classification
• Escalation Rules - Triggers human review for complex cases
• ClinEval Benchmark - Validates clinical accuracy

Example Output

TREATMENT PLAN

Patient: [De-identified ID: TP-2024-0142]
Age Range: 55-60 years
Primary Diagnosis: Type 2 Diabetes Mellitus, uncontrolled (E11.65)
Secondary Diagnoses: Essential Hypertension (I10), Obesity (E66.9)

TREATMENT GOALS

Short-term (3 months):
1. Reduce HbA1c from 9.2% to <8%
2. Achieve blood pressure <140/90 mmHg
3. Initiate regular physical activity (150 min/week)

Long-term (12 months):
1. Maintain HbA1c <7%
2. Achieve 5% body weight reduction
3. Prevent microvascular complications

INTERVENTIONS

Pharmacological:
- Metformin 500mg BID, titrate to 1000mg BID over 4 weeks
- Lisinopril 10mg daily, adjust per BP response
- Continue current statin therapy

Non-pharmacological:
- Medical nutrition therapy referral
- Diabetes self-management education
- Moderate aerobic activity 30 min/day, 5 days/week

MONITORING

- HbA1c every 3 months until at goal
- Home blood glucose log weekly
- Blood pressure check every visit
- Annual comprehensive metabolic panel
- Annual foot exam and eye exam

FOLLOW-UP

- Return in 4 weeks for medication titration
- Call clinic if fasting glucose >250 or symptoms
- Quarterly visits once stable

References

• See references/clinical-guidelines.md for complete guideline references
• See references/icd10-codes.md for common diagnosis codes
• See references/medication-protocols.md for prescribing guidelines