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Preparation & Sharing of Care Plans

Preparation & Sharing of Care Plans

ID

CO-05

Type

Core Requirement

Status

Published

Release

V3.0 - March 2023

CO-05 Preparation & sharing of care plans

  • Enable preparation and sharing of care planning with appropriate consent controls. Both within the EPR/trust boundary and local or national systems (as appropriate).

Core Level Requirements

Description

The care plan is a crucial item within the community care setting detailing the short and long-term treatment for a patient across multiple settings. These care plans need to be as straightforward to create as possible and need to be updatable. The care plan is created by multiple people including the patient themselves and needs to be viewable by multiple people that may be in or outside of the care provider's organisation.

User Stories

CO-05.1 Creating Care Plans

CO-05.1 Creating Care Plans

DCF Core Capability

As a clinical professional,

I want to be able to create a care plan,

So that patient and clinicians know what treatments the patient requires.

Acceptance criteria 1:

Given the user has the correct permissions,

When viewing a patient record,

Then a care plan can be created.

Application Function

Description

AF316 Cross Organisational Workflow

Review of care plan by clinicians across multiple organisations

Standards Compliance

STD004 AIDC: Automatic Identification and Data Capture

STD013 Child Protection Information Sharing

STD030 Digital Imaging and Communications in Medicine (DICOM)

STD039 Health and Social Care Organisation Reference Data

STD043 Identity Verification and Authentication Standard for Digital Health and Care Services

STD045 Data Security and Protection Toolkit

STD080 UK Edition SNOMED CT

STD097 Outpatient letter

STD116 Personalised Care and Support Plan

STD117 Care homes view of shared care records

CO-05.2 Sharing Care Plans

CO-05.2 Sharing Care Plans

DCF Core Capability

As a clinical professional,

I want to be able to share the care plan digitally with other care providers and patient / family etc,

So that all parties involved can see the plan.

Acceptance criteria 1:

Given the user has the correct permissions,

When sharing a care plan to other care providers, patients, families, carers etc,

Then a digital version of the care plan can be shared.

Application Function

Description

AF317 Patient access to records

The ability of an authenticated patient to be able to view their own medical record including:

  • All relevant documents, e.g. discharge summary, care plans

  • All relevant part of care record.

  • Ability to specify contact preferences

Note: It must be possible for clinicians to be able to restrict information for sharing with the patient via the portal where necessary.

AF341 Digital Presentation of Handover Data

The system provides a digital presentation of patient data including context as part of a digital handover to enable the sharing of relevant patient data without the need for paper-based handover notes

AF337 Share summary patient data

the system to make every patient’s digitally recorded consent decisions electronically accessible to services across the Trust and region and with the national care record

Standards Compliance

STD001 Accessible Information

STD004 AIDC: Automatic Identification and Data Capture

STD013 Child Protection Information Sharing

STD039 Health and Social Care Organisation Reference Data

STD043 Identity Verification and Authentication Standard for Digital Health and Care Services

STD045 Data Security and Protection Toolkit

STD097 Outpatient letter

STD116 Personalised Care and Support Plan

STD117 Care homes view of shared care records

CO-05.3 Sharing Care Plans (paper copy)

CO-05.3 Sharing Care Plans (paper copy)

DCF Core Capability

As a clinical professional,

I want to be able to share a paper copy of the care plan,

So that any party that cannot access a digital copy can still receive the plan.

Acceptance criteria 1:

Given the user has the correct permissions,

When sharing a care plan to other care providers, patients, families, carers etc,

And a digital copy cannot be shared,

Then a paper copy of the care plan can be created.

Application Function

Description

AF366 Produce hardcopy data extracts

the ability to export/share healthcare data in hard copy.

Standards Compliance

STD001 Accessible Information

STD004 AIDC: Automatic Identification and Data Capture

STD013 Child Protection Information Sharing

STD039 Health and Social Care Organisation Reference Data

STD043 Identity Verification and Authentication Standard for Digital Health and Care Services

STD045 Data Security and Protection Toolkit

STD097 Outpatient letter

STD116 Personalised Care and Support Plan

STD117 Care homes view of shared care records

CO-05.4 Sharing Care Plans (via Trust or National Systems)

CO-05.4 Sharing Care Plans (via Trust or National Systems)

DCF Core Capability

As a clinical professional,

I want to be able to share the care plan with the trust or national bodies,

So that all parties involved can see the plan.

Acceptance criteria 1:

Given the user has the correct permissions,

When it is required by the trust or other national bodies,

Then the care plan can be shared with these parties.

Application Function

Description

AF378 Care plan sharing

The system should be able to share Care Plans across the Trust systems and with national bodies

Standards Compliance

STD004 AIDC: Automatic Identification and Data Capture

STD013 Child Protection Information Sharing

STD039 Health and Social Care Organisation Reference Data

STD043 Identity Verification and Authentication Standard for Digital Health and Care Services

STD045 Data Security and Protection Toolkit

STD097 Outpatient letter

STD116 Personalised Care and Support Plan

STD117 Care homes view of shared care records

CO-05.5 Care Plans (Images & Documents)

CO-05.5 Care Plans (Images & Documents)

DCF Core Capability

As a Healthcare or Clinical Professional,

I want to add images or documents into the patient care plan,

So that these artefacts are stored with the care record

Acceptance criteria 1:

Given the user has permission to view and edit the patient record,

When amending a care plan,

Then documents and images can be added to the patient record.

Application Function

Description

AF155 View Patient Record (current)

This is the ability to view the data and documents added to a patient record as part of the current episode.

AF156 View Patient Record (historic)

This is the ability to view the data and documents added to a patient record as part of a historic episode.

Standards Compliance

STD001 Accessible Information

STD004 AIDC: Automatic Identification and Data Capture

STD013 Child Protection Information Sharing

STD030 Digital Imaging and Communications in Medicine (DICOM)

STD043 Identity Verification and Authentication Standard for Digital Health and Care Services

STD045 Data Security and Protection Toolkit

STD080 UK Edition SNOMED CT

STD097 Outpatient letter

STD116 Personalised Care and Support Plan

CO-05.6 Consent

CO-05.6 Consent

DCF Core Capability

As a clinical professional,

I want to be able to record the patient's consent to the care record, for the sharing of the information in their care plan with other organisations, family members, etc.

So that the information in their care plan is only shared with trusted parties.

Acceptance criteria 1:

Given that the patient has given consent to share information,

When viewing or editing the patient record,

Then permission to share the care plan can be recorded

And this information is visible to the appropriate users.

Application Function

Description

AF379 Record Patient Consent to Data Sharing

The ability of the system to record the patients content to sharing data with other services e.g. Care Plan

Standards Compliance

STD116 Personalised Care and Support Plan

CO-05.7 Templates

CO-05.7 Templates

DCF Core Capability

As a system administrator,

I want to be able to create and maintain templates for any form of data entry in different care pathways,

So that the system user can easily create a care plan from one or more templates for structured data input,

And these templates are maintained by a limited number of users.

Acceptance criteria 1:

Given that the user has admin-level permissions,

When viewing the care pathway templates,

Then they are able to create, remove, upload or delete a pathway template.

Application Function

Description

AF380 Create and maintain templates for care pathways

The ability of the system to allow appropriately privileged users to create and modify templates for the various care pathways

Standards Compliance

STD043 Identity Verification and Authentication Standard for Digital Health and Care Services

STD045 Data Security and Protection Toolkit

STD116 Personalised Care and Support Plan

Applicable Standards

Applicable Standards

The full list of standards applicable to the community care setting are contained at the link below

Community Care Standards