Healthcare

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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

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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