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Treatment Plans Skill

Overview

Skill for generating concise, clinician-focused medical treatment plans across all clinical specialties. Provides LaTeX/PDF templates with SMART goal frameworks, evidence-based interventions, regulatory compliance, and validation tools for patient-centered care planning.

Default to 1-page format for most cases - think "quick reference card" not "comprehensive textbook".

What's Included

📋 Seven Treatment Plan Types

One-Page Treatment Plan (PREFERRED) - Concise, quick-reference format for most clinical scenarios
General Medical Treatment Plans - Primary care, chronic diseases (diabetes, hypertension, heart failure)
Rehabilitation Treatment Plans - Physical therapy, occupational therapy, cardiac/pulmonary rehab
Mental Health Treatment Plans - Psychiatric care, depression, anxiety, PTSD, substance use
Chronic Disease Management Plans - Complex multimorbidity, long-term care coordination
Perioperative Care Plans - Preoperative optimization, ERAS protocols, postoperative recovery
Pain Management Plans - Acute and chronic pain, multimodal analgesia, opioid-sparing strategies

📚 Reference Files (5 comprehensive guides)

treatment_plan_standards.md - Professional standards, documentation requirements, legal considerations
goal_setting_frameworks.md - SMART goals, patient-centered outcomes, shared decision-making
intervention_guidelines.md - Evidence-based treatments, pharmacological and non-pharmacological
regulatory_compliance.md - HIPAA compliance, billing documentation, quality measures
specialty_specific_guidelines.md - Detailed guidelines for each treatment plan type

📄 LaTeX Templates (7 professional templates)

one_page_treatment_plan.tex - FIRST CHOICE - Dense, scannable 1-page format (like precision oncology reports)
general_medical_treatment_plan.tex - Comprehensive medical care planning
rehabilitation_treatment_plan.tex - Functional restoration and therapy
mental_health_treatment_plan.tex - Psychiatric and behavioral health
chronic_disease_management_plan.tex - Long-term disease management
perioperative_care_plan.tex - Surgical and procedural care
pain_management_plan.tex - Multimodal pain treatment

🔧 Validation Scripts (4 automation tools)

generate_template.py - Interactive template selection and generation
validate_treatment_plan.py - Comprehensive quality and compliance checking
check_completeness.py - Verify all required sections present
timeline_generator.py - Create visual treatment timelines and schedules

Quick Start

Generate a Treatment Plan Template

cd .claude/skills/treatment-plans/scripts
python generate_template.py

# Or specify type directly
python generate_template.py --type general_medical --output diabetes_plan.tex

Available template types:

one_page (PREFERRED - use for most cases)
general_medical
rehabilitation
mental_health
chronic_disease
perioperative
pain_management

Compile to PDF

cd /path/to/your/treatment/plan
pdflatex my_treatment_plan.tex

Validate Your Treatment Plan

# Check for completeness
python check_completeness.py my_treatment_plan.tex

# Comprehensive validation
python validate_treatment_plan.py my_treatment_plan.tex

Generate Treatment Timeline

python timeline_generator.py --plan my_treatment_plan.tex --output timeline.pdf

Standard Treatment Plan Components

All templates include these essential sections:

1. Patient Information (De-identified)

Demographics and relevant medical background
Active conditions and comorbidities
Current medications and allergies
Functional status baseline
HIPAA-compliant de-identification

2. Diagnosis and Assessment Summary

Primary diagnosis (ICD-10 coded)
Secondary diagnoses
Severity classification
Functional limitations
Risk stratification

3. Treatment Goals (SMART Format)

Short-term goals (1-3 months):

Specific, measurable outcomes
Realistic targets with defined timeframes
Patient-centered priorities

Long-term goals (6-12 months):

Disease control targets
Functional improvement objectives
Quality of life enhancement
Complication prevention

4. Interventions

Pharmacological: Medications with dosages, frequencies, monitoring
Non-pharmacological: Lifestyle modifications, behavioral interventions, education
Procedural: Planned procedures, specialist referrals, diagnostic testing

5. Timeline and Schedule

Treatment phases with timeframes
Appointment frequency
Milestone assessments
Expected treatment duration

6. Monitoring Parameters

Clinical outcomes to track
Assessment tools and scales
Monitoring frequency
Intervention thresholds

7. Expected Outcomes

Primary outcome measures
Success criteria
Timeline for improvement
Long-term prognosis

8. Follow-up Plan

Scheduled appointments
Communication protocols
Emergency procedures
Transition planning

9. Patient Education

Condition understanding
Self-management skills
Warning signs
Resources and support

10. Risk Mitigation

Adverse effect management
Safety monitoring
Emergency action plans
Fall/infection prevention

Common Use Cases

1. Type 2 Diabetes Management

Goal: Create comprehensive treatment plan for newly diagnosed diabetes

Template: general_medical_treatment_plan.tex

Key Components:
- SMART goals: HbA1c <7% in 3 months, weight loss 10 lbs in 6 months
- Medications: Metformin titration schedule
- Lifestyle: Diet, exercise, glucose monitoring
- Monitoring: HbA1c every 3 months, quarterly visits
- Education: Diabetes self-management education

2. Post-Stroke Rehabilitation

Goal: Develop rehab plan for stroke patient with hemiparesis

Template: rehabilitation_treatment_plan.tex

Key Components:
- Functional assessment: FIM scores, ROM, strength testing
- PT goals: Ambulation 150 feet with cane in 12 weeks
- OT goals: Independent ADLs, upper extremity function
- Treatment schedule: PT/OT/SLP 3x week each
- Home exercise program

3. Major Depressive Disorder

Goal: Create integrated treatment plan for depression

Template: mental_health_treatment_plan.tex

Key Components:
- Assessment: PHQ-9 score 16 (moderate depression)
- Goals: Reduce PHQ-9 to <5, return to work in 12 weeks
- Psychotherapy: CBT weekly sessions
- Medication: SSRI with titration schedule
- Safety planning: Crisis contacts, warning signs

4. Total Knee Replacement

Goal: Perioperative care plan for elective TKA

Template: perioperative_care_plan.tex

Key Components:
- Preop optimization: Medical clearance, medication management
- ERAS protocol implementation
- Postop milestones: Ambulation POD 1, discharge POD 2-3
- Pain management: Multimodal analgesia
- Rehab plan: PT starting POD 0

5. Chronic Low Back Pain

Goal: Multimodal pain management plan

Template: pain_management_plan.tex

Key Components:
- Pain assessment: Location, intensity, functional impact
- Goals: Reduce pain 7/10 to 3/10, return to work
- Medications: Non-opioid analgesics, adjuvants
- PT: Core strengthening, McKenzie exercises
- Behavioral: CBT for pain, mindfulness
- Interventional: Consider ESI if inadequate response

SMART Goals Framework

All treatment plans use SMART criteria for goal-setting:

Specific: Clear, well-defined outcome (not vague)
Measurable: Quantifiable metrics or observable behaviors
Achievable: Realistic given patient capabilities and resources
Relevant: Aligned with patient priorities and values
Time-bound: Specific timeframe for achievement

Examples

Good SMART Goals:

Reduce HbA1c from 8.5% to <7% within 3 months
Walk independently 150 feet with assistive device by 8 weeks
Decrease PHQ-9 depression score from 18 to <10 in 8 weeks
Achieve knee flexion >90 degrees by postoperative day 14
Reduce pain from 7/10 to ≤4/10 within 6 weeks

Poor Goals (not SMART):

"Feel better" (not specific or measurable)
"Improve diabetes" (not specific or time-bound)
"Get stronger" (not measurable)
"Return to normal" (vague, not specific)

Workflow Examples

Standard Treatment Plan Workflow

Assess patient - Complete history, physical, diagnostic testing
Select template - Choose appropriate template for clinical context
Generate template - python generate_template.py --type [type]
Customize plan - Fill in patient-specific information (de-identified)
Set SMART goals - Define measurable short and long-term goals
Specify interventions - Evidence-based pharmacological and non-pharmacological
Create timeline - Schedule appointments, milestones, reassessments
Define monitoring - Outcome measures, assessment frequency
Validate completeness - python check_completeness.py plan.tex
Quality check - python validate_treatment_plan.py plan.tex
Review quality checklist - Compare to quality_checklist.md
Generate PDF - pdflatex plan.tex
Review with patient - Shared decision-making, confirm understanding
Implement and document - Execute plan, track progress in clinical notes
Reassess and modify - Adjust plan based on outcomes

Multidisciplinary Care Plan Workflow

Identify team members - PCP, specialists, therapists, case manager
Create base plan - Generate template for primary condition
Add specialty sections - Integrate consultant recommendations
Coordinate goals - Ensure alignment across disciplines
Define communication - Team meeting schedule, documentation sharing
Assign responsibilities - Clarify who manages each intervention
Create care timeline - Coordinate appointments across providers
Share plan - Distribute to all team members and patient
Track collectively - Shared monitoring and outcome tracking
Regular team review - Adjust plan collaboratively

Best Practices

Patient-Centered Care

✓ Involve patients in goal-setting and decision-making
✓ Respect cultural beliefs and language preferences
✓ Address health literacy with appropriate language
✓ Align plan with patient values and life circumstances
✓ Support patient activation and self-management

Evidence-Based Practice

✓ Follow current clinical practice guidelines
✓ Use interventions with proven efficacy
✓ Incorporate quality measures (HEDIS, CMS)
✓ Avoid low-value or ineffective interventions
✓ Update plans based on emerging evidence

Regulatory Compliance

✓ De-identify per HIPAA Safe Harbor method (18 identifiers)
✓ Document medical necessity for billing support
✓ Include informed consent documentation
✓ Sign and date all treatment plans
✓ Maintain professional documentation standards

Quality Documentation

✓ Complete all required sections
✓ Use clear, professional medical language
✓ Include specific, measurable goals
✓ Specify exact medications (dose, route, frequency)
✓ Define monitoring parameters and frequency
✓ Address safety and risk mitigation

Care Coordination

✓ Communicate plan to entire care team
✓ Define roles and responsibilities
✓ Coordinate across care settings
✓ Integrate specialist recommendations
✓ Plan for care transitions

Integration with Other Skills

Clinical Reports

SOAP Notes: Document treatment plan implementation and progress
H&P Documents: Initial assessment informs treatment planning
Discharge Summaries: Summarize treatment plan execution
Progress Notes: Track goal achievement and plan modifications

Scientific Writing

Citation Management: Reference clinical practice guidelines
Literature Review: Understand evidence base for interventions
Research Lookup: Find current treatment recommendations

Research

Research Grants: Treatment protocols for clinical trials
Clinical Trial Reports: Document trial interventions

Clinical Practice Guidelines

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
KDIGO Chronic Kidney Disease Guidelines

Rehabilitation

APTA Physical Therapy Clinical Practice Guidelines
AOTA Occupational Therapy Practice Guidelines
AHA/AACVPR Cardiac Rehabilitation Guidelines
Stroke Rehabilitation Best Practices

Mental Health

APA (American Psychiatric Association) Practice Guidelines
VA/DoD Clinical Practice Guidelines for Mental Health
NICE Guidelines (UK)
Evidence-based psychotherapy protocols (CBT, DBT, ACT)

Pain Management

CDC Opioid Prescribing Guidelines
AAPM (American Academy of Pain Medicine) Guidelines
WHO Analgesic Ladder
Multimodal Analgesia Best Practices

Perioperative Care

ERAS (Enhanced Recovery After Surgery) Society Guidelines
ASA Perioperative Guidelines
SCIP (Surgical Care Improvement Project) Measures

Professional Standards

Documentation Requirements

Complete and accurate patient information
Clear diagnosis with appropriate ICD-10 coding
Evidence-based interventions
Measurable goals and outcomes
Defined monitoring and follow-up
Provider signature, credentials, and date

Medical Necessity

Treatment plans must demonstrate:

Medical appropriateness of interventions
Alignment with diagnosis and severity
Evidence supporting treatment choices
Expected outcomes and benefit
Frequency and duration justification

Legal Considerations

Informed consent documentation
Patient understanding and agreement
Risk disclosure and mitigation
Professional liability protection
Compliance with state/federal regulations

Support and Resources

Getting Help

Check reference files - Comprehensive guidance in references/ directory
Review templates - See example structures in assets/ directory
Run validation scripts - Identify issues with automated tools
Consult SKILL.md - Detailed documentation and best practices
Review quality checklist - Ensure all quality criteria met

External Resources

Clinical practice guidelines from specialty societies
UpToDate and DynaMed for treatment recommendations
AHRQ Effective Health Care Program
Cochrane Library for intervention evidence
CMS Quality Measures and HEDIS specifications
HEDIS (Healthcare Effectiveness Data and Information Set)

Professional Organizations

American Medical Association (AMA)
American Academy of Family Physicians (AAFP)
Specialty society guidelines (ADA, ACC, AHA, APA, etc.)
Joint Commission standards
Centers for Medicare & Medicaid Services (CMS)

Frequently Asked Questions

How do I choose the right template?

Match the template to your primary clinical focus:

Chronic medical conditions → general_medical or chronic_disease
Post-surgery or injury → rehabilitation or perioperative
Psychiatric conditions → mental_health
Pain as primary issue → pain_management

What if my patient has multiple conditions?

Use the chronic_disease_management_plan.tex template for complex multimorbidity, or choose the template for the primary condition and add sections for comorbidities.

How often should treatment plans be updated?

Initial creation: At diagnosis or treatment initiation
Regular updates: Every 3-6 months for chronic conditions
Significant changes: When goals are met or treatment is modified
Annual review: Minimum for all chronic disease plans

Can I modify the LaTeX templates?

Yes! Templates are designed to be customized. Modify sections, add specialty-specific content, or adjust formatting to meet your needs.

How do I ensure HIPAA compliance?

Remove all 18 HIPAA identifiers (see Safe Harbor method)
Use age ranges instead of exact ages (e.g., "60-65" not "63")
Remove specific dates, use relative timelines
Omit geographic identifiers smaller than state
Use check_deidentification.py script from clinical-reports skill

What if validation scripts find issues?

Review the specific issues identified, consult reference files for guidance, and revise the plan accordingly. Common issues include:

Missing required sections
Goals not meeting SMART criteria
Insufficient monitoring parameters
Incomplete medication information

License

Part of the Claude Scientific Writer project. See main LICENSE file.

For detailed documentation, see SKILL.md. For issues or questions, consult the comprehensive reference files in the references/ directory.

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