Explore Care Plans and Care Plan Templates
Learning Objectives
After completing this unit, you’ll be able to:
- Describe the components of the care plans.
- List the use of care plan templates.
- Explain how care plan templates are used.
Prerequisites
Before you start this module, consider the recommended prerequisites to best prepare you to learn.
Recommended
Completion of these modules:
Learn About Care Plans
- Starting with the Spring ’23 release, you can use Integrated Care Management (ICM) in Health Cloud. Integrated Care Management is a care plan solution built directly on the Salesforce platform.
- All development in Health Cloud is now built on the FHIR R4-aligned Integrated Care Management data model. Unlike the older Care Plans model, there is no dependency on the Health Cloud managed package. The packaged objects in the Care Plans data model won’t be used for future development.
If you try to break a bunch of sticks, you are likely to hurt yourself. The most effective way to do it is to snap one stick at a time. Healthcare problems are similar. For an elderly patient recovering from a hip injury, providing care can be difficult. Coupled with existing conditions like diabetes, the problem becomes complicated. But this care problem can be tackled if we break it down into actionable units.
Which brings us to care plans.
Care plans are practical, actionable steps to support the health of a patient. They are widely used because they break health problems down into doable, trackable actions. Care plans serve as the source of truth for all the individuals involved in the care of a member.
Care plans consist of problems, goals, tasks, and care teams. Traditionally, a task would nest under a goal and a goal would nest under a problem. But now problems and goals are optional. A task either rolls up to a care plan or problem directly, or it follows the traditional structure of rolling up to a goal. Each care plan can also be assigned a care team. A care team consists of individuals in the patient’s network who work together to improve the patient’s health.
Let’s look at a few components that make up a care plan.
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Problem: A problem is a clinical or nonclinical health issue identified as a priority for the patient. It can be a specific diagnosis identified by a care professional or a lab test. Or it can be a general issue reported by the patient. Let’s take the example of Charles Green who has diabetes. The problem would be High Blood Sugar.
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Goal: A health goal represents a targeted outcome to be achieved by the patient in order to overcome the problem. A patient can have more than one goal associated with a problem. For Charles, a care plan goal would be Reduce fasting blood sugar level to below 100mg/dL (milligrams per deciliter).
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Task: A task is the primary driver of a care plan. Tasks denote a measurable action toward a goal. They help track the progress of the activities associated with a problem. To follow Charles Green’s story, a care plan task would be Dietary Changes.
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Care team: A care team is the support hub of a patient’s community. It consists of individuals and professionals who work together to improve the patient’s health. Care team members may be given ownership of specific tasks to help patients successfully manage their health. A care team for Charles Green consists of his primary care physician, his care coordinator, his caregiver Shawna Green, his endocrinologist, and so on.
With care plans, you can:
- Provide standardized care across similar problems and patients, so that care gaps are easily identified.
- Improve health outcomes by getting patients engaged in their health journeys.
- Ensure tasks are managed successfully by involving the patient’s network and giving them ownership of actions.
- Reduce the risk of readmission as well as the cost of care.
Get Started with Care Plan Templates
Care plan templates are standardized care plans with a list of actions tailored to a patient’s specific health needs. With a few clicks, care coordinators assign a care plan template with problems, goals, and tasks prefilled for a particular diagnosis. This saves time and effort, and ensures standardized care across patient groups.
Care plan templates combine proven strategies with specific health needs. Think of care plan templates as the structure for care plans. They offer predefined care protocols with automated tasks and goals. They enable care coordinators to apply standard care across patient groups, instead of having to enter standard protocols for each patient.
Users can also set up prebuilt templates for specific health conditions. The templates are already populated with a tried-and-tested list of actions and follow-up steps. For instance, for a group of patients who are all recovering from surgery, the care coordinator can assign a care plan template that includes follow-up actions such as routine check-up at home, pain management, physical therapy sessions, and more.
Care plan templates are flexible. Care coordinators customize them keeping in mind the individual needs of the patients. Care coordinators can add or remove a task or change the offset date or the start date. In this way, they can ensure a personalized experience for the patients.
We'll return to this point in the next section.
To summarize, care plan template are useful because:
- They standardize the workflow and ensure integrated care.
- They save time and minimize effort.
- They personalize the experience for the patient.
- They increase patient engagement, thus leading to stronger relationships with the patient.
Use a Care Plan Template
Bloomington Caregivers recently moved to Health Cloud. Harryette Randall, the Salesforce admin, plans to set up care plans for care coordinator April Guthman to manage her patients. Once the Health Cloud Lightning Console is set up, April can better care for her patients, many of whom have common health concerns. If April could create a standardized care plan for her patients with similar ailments like diabetes, it would simplify her workload, save time, and help her identify care gaps that need immediate attention.
Luckily for April, plan templates are set up once and reused multiple times. What’s more, they are customizable to suit each patient’s individual needs. April herself can set it up with only a few clicks from the Health Cloud Lightning Console. You'll learn about the setup steps in detail in the next unit.
April wants to create a new care plan. She can choose from a list of care plan templates that are already available or select multiple care plan templates for patients with more than one health issue. For example, she selects the care plan template Care Plan for Diabetes, which has a number of related problems, goals, and tasks that are prepopulated.
But April doesn’t need all the tasks and goals that are associated with the template.
- If April wants to remove the task Daily Exercise: Morning Walk, she simply deselects that particular task. (1)
- To set a Due Date of 10 days for the task Blood Sugar Check, April edits the offset date. (2)
- After clicking Next, April adds the care team members and reviews the care plan before saving it. Even after saving the care plan, she can add a new problem, goal, or task and edit an existing component.
- She customizes the “Group by” view to view the tasks.
- Once it’s complete, April closes the task by selecting the checkbox next to it.
The care plan template offers a great deal of flexibility when it comes to setting up a customized care plan for a patient. The creation process is streamlined to only a few clicks. This saves time and makes things simple and easy for the care coordinators like April. But to get there, let’s walk through all steps that are required to set up and customize care plans.
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