Skill: rithythul/koompi-healthcare (version 0.2.1)

--- name: healthcare description: Use for clinic and healthcare facility operations — patient scheduling, medical records, prescriptions, lab tracking, staff coordination, billing, compliance, and patient communication. version: "0.1.0" author: koompi tags: - healthcare - clinic - patient-scheduling - medical-records - prescriptions --- # Healthcare & Clinic Operations Skill Assist clinics and healthcare facilities with patient management, scheduling, documentation, and operational workflows. Prioritize patient safety, data privacy, and clear communication at all times. ## Heartbeat When activated during a heartbeat cycle: 1. **Appointments needing confirmation?** Any unconfirmed appointments in the next 48 hours → send reminders 2. **Prescription refills due?** Patients with refills expiring in ≤7 days → flag for provider review and notify patient 3. **Lab results pending?** Results received but not reviewed by provider → alert; results older than 72 hours → escalate 4. **Follow-up visits overdue?** Patients past their scheduled follow-up window → generate outreach list 5. **Staff schedule gaps?** Shifts in next 7 days with no coverage → flag for clinic manager 6. If nothing needs attention → `HEARTBEAT_OK` ## Patient Scheduling ### Appointment Types - **New patient intake:** 45-60 min. Requires registration, insurance info, medical history forms sent in advance. - **Follow-up visit:** 15-30 min. Pull prior visit notes and pending orders before appointment. - **Urgent/walk-in:** Triage immediately. Slot into first available gap or add to overflow. - **Telehealth:** Confirm patient has link and device access. Send connection instructions 1 hour before. - **Procedure/lab visit:** Block appropriate time + equipment. Confirm prep instructions sent to patient. ### Scheduling Rules - No double-booking unless provider explicitly allows overbooking slots - Buffer 5-10 min between appointments for documentation - Flag if a provider exceeds daily patient cap - Keep urgent slots open each day (minimum 2 per provider) - When rescheduling, offer next 3 available slots ### Appointment Reminders - 48 hours before: initial reminder (SMS/message preferred, fallback to call) - 24 hours before: confirmation request — patient must confirm or reschedule - 2 hours before: final reminder with arrival instructions - No-show: contact within 1 hour, offer rebooking, log the no-show ## Medical Records & Documentation ### Visit Documentation Structure ``` Patient: [name, ID] Date: [date] | Provider: [name] Visit type: [new/follow-up/urgent/telehealth] Chief complaint: [patient's stated reason] History of present illness: [details] Examination findings: [relevant findings] Assessment: [diagnosis/impression] Plan: [treatment, prescriptions, referrals, follow-up] ``` ### Documentation Principles - Record at the time of encounter or immediately after — never backfill from memory - Use objective language: "patient reports..." not "patient claims..." - Every entry must have date, time, provider name - Corrections: never delete — append a dated addendum - Templates speed up documentation but always review before finalizing ### Record Requests - Verify patient identity before releasing any records - Log every access and release - Provide records within the timeframe required by local regulation (default: 30 days) - Redact information not covered by the request scope ## Prescription Management ### New Prescriptions - Verify: drug name, dosage, frequency, duration, route - Check for documented allergies and current medications — flag interactions - Include clear patient instructions: when to take, with/without food, side effects to watch for - Log prescribing provider, date, and indication ### Refill Workflow 1. Patient requests refill (message, call, or in-person) 2. Check: last fill date, remaining refills, next appointment date 3. If refills remaining and patient is adherent → process refill 4. If no refills or patient overdue for visit → schedule appointment before refilling 5. Controlled substances: always require provider review, no auto-refills 6. Notify patient when refill is ready for pickup/delivery ### Medication List Maintenance - Keep an active, accurate medication list per patient - Reconcile at every visit: add new, remove discontinued, verify doses - Flag: duplicate therapies, expired prescriptions, medications without a recent review ## Follow-Up Care Coordination ### After Visit - Schedule follow-up before patient leaves (or within 24 hours for telehealth) - Send visit summary to patient: diagnosis, medications, next steps, when to return - Referrals: send within 48 hours, confirm receiving provider has the referral, track status ### Chronic Disease Management - Maintain a care plan per condition: target metrics, medication, visit frequency, lifestyle goals - Track key indicators: HbA1c, blood pressure, weight, pain scores — whatever applies - Alert when a patient misses a monitoring milestone - Coordinate between specialists — ensure shared care plan is current ### Referral Tracking ``` Patient: [name, ID] Referring provider: [name] Referred to: [specialist, facility] Reason: [indication] Date sent: [date] Status: [pending / scheduled / completed / no response] Follow-up if no response: [date + 7 days] ``` ## Lab Results & Test Tracking ### Ordering - Every lab order needs: test name, indication, ordering provider, urgency level - Confirm specimen requirements and patient prep instructions - Send patient prep instructions at time of ordering (fasting, medication holds, etc.) ### Results Workflow 1. Results received → route to ordering provider 2. Provider reviews within 24 hours (critical values: immediately) 3. Normal results → notify patient within 48 hours 4. Abnormal results → provider contacts patient directly, documents discussion and plan 5. Critical results → immediate provider notification + patient contact + document time stamps ### Pending Test Tracker - Maintain a list of all ordered tests with expected result dates - Flag overdue results (>3 days past expected) - Escalate: contact lab if results are late, notify provider ## Staff Scheduling ### Shift Management - Weekly schedule: provider, nursing, admin, support staff - Minimum staffing requirements per shift (at least 1 provider + 1 nursing + 1 admin during open hours) - Flag: overtime approaching limits, consecutive shifts without rest, uncovered shifts - On-call roster: always have a designated after-hours contact ### Leave & Coverage - Leave requests: submitted ≥2 weeks in advance for planned leave - Find coverage before approving leave — never leave a shift unstaffed - Sick calls: immediately find replacement, notify affected patients if appointments must move - Track leave balances: annual, sick, continuing education ## Insurance & Billing ### Pre-Visit - Verify insurance eligibility before appointment - Check if referral/prior authorization is required — obtain before visit - Inform patient of estimated out-of-pocket costs when possible ### Post-Visit Billing - Code visits accurately: diagnosis codes + procedure codes matching documentation - Submit claims within the payer's filing deadline - Track claim status: submitted → accepted → paid / denied ### Denied Claims 1. Identify denial reason (coding error, missing auth, eligibility, medical necessity) 2. Correct and resubmit or file appeal within allowed timeframe 3. Log all denials — review monthly for patterns 4. Common fixes: missing modifier, wrong diagnosis code, expired authorization ### Patient Billing - Send statements within 30 days of service or insurance adjudication - Itemize charges clearly — patients should understand what they're paying for - Offer payment plans for balances above a threshold set by the clinic - Collections: only after 90 days + 3 contact attempts + documented financial hardship screening ## Patient Communication ### Templates - **Appointment reminder:** Date, time, provider, location, prep instructions, how to reschedule - **Lab results (normal):** Results summary, "no action needed," next scheduled screening date - **Lab results (abnormal):** Brief note that provider will call to discuss, do not include raw values in unsecured messages - **Prescription ready:** Medication name, pickup location, take-as-directed reminder - **Missed appointment:** Reschedule prompt, note that continuity of care matters - **Referral update:** Specialist name, date, location, what to bring - **Balance due:** Amount, due date, payment options, contact for questions ### Communication Rules - Never include detailed diagnoses, test values, or sensitive information in unsecured messages - Always identify the clinic and provide a callback number - Respond to patient inquiries within 1 business day - Urgent clinical questions → route to provider, not administrative staff - Use plain language — no medical jargon in patient-facing messages ## Compliance & Privacy ### Core Privacy Principles - **Minimum necessary:** Only access or share the minimum information needed for the task - **Need to know:** Staff access records only for patients they are actively treating or supporting - **Patient consent:** Obtain consent before sharing records with third parties (except where legally required) - **Audit trail:** Log every access, modification, and disclosure of patient records - **De-identification:** Remove names, IDs, dates of birth, and other identifiers when using data for reporting or analysis ### Operational Safeguards - Lock screens when unattended. Auto-lock after 5 minutes of inactivity. - Never discuss patient information in public areas - Verify identity before disclosing any information by phone or message - Shred physical documents containing patient information - Report any suspected breach immediately to the clinic's privacy officer ### Retention - Retain records for the period required by local regulation (default minimum: 7 years for adults, until age of majority + 7 years for minors) - Secure destruction after retention period — document the destruction ## Emergency Escalation ### Triage Priority - **Immediate (red):** Life-threatening — chest pain, difficulty breathing, severe bleeding, loss of consciousness → call emergency services, do not wait - **Urgent (orange):** Needs same-day attention — high fever, acute pain, worsening symptoms → provider assessment within 1 hour - **Semi-urgent (yellow):** Needs attention within 24-48 hours — persistent symptoms, medication reactions, post-procedure concerns → schedule urgent visit - **Routine (green):** Standard scheduling — chronic management, preventive care, refills ### Escalation Protocol 1. Identify severity using triage categories above 2. Immediate → call emergency services + notify on-site provider + document time of identification and actions taken 3. Urgent → pull patient chart, alert provider, prepare exam room 4. Document every escalation: who identified, when, what action, outcome 5. Post-event review for all immediate and urgent cases within 48 hours ### After-Hours - Route to on-call provider for urgent/immediate concerns - Non-urgent → acknowledge receipt, schedule next-day follow-up - Always provide emergency service contact info in after-hours messages


Security scan verdicts — ClawScan: suspicious | static analysis: clean | VirusTotal: clean | SkillSpector: clean (LOW)