@synsci/cli-darwin-x64 1.1.97 → 1.1.99

package/bin/skills/treatment-plans/SKILL.md

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----
-name: treatment-plans
-description: "Generate concise (3-4 page), focused medical treatment plans in LaTeX/PDF format for all clinical specialties. Supports general medical treatment, rehabilitation therapy, mental health care, chronic disease management, perioperative care, and pain management. Includes SMART goal frameworks, evidence-based interventions with minimal text citations, regulatory compliance (HIPAA), and professional formatting. Prioritizes brevity and clinical actionability."
-allowed-tools: [Read, Write, Edit, Bash]
----
-
-# Treatment Plan Writing
-
-## Overview
-
-Treatment plan writing is the systematic documentation of clinical care strategies designed to address patient health conditions through evidence-based interventions, measurable goals, and structured follow-up. This skill provides comprehensive LaTeX templates and validation tools for creating **concise, focused** treatment plans (3-4 pages standard) across all medical specialties with full regulatory compliance.
-
-**Critical Principles:**
-1. **CONCISE & ACTIONABLE**: Treatment plans default to 3-4 pages maximum, focusing only on clinically essential information that impacts care decisions
-2. **Patient-Centered**: Plans must be evidence-based, measurable, and compliant with healthcare regulations (HIPAA, documentation standards)
-3. **Minimal Citations**: Use brief in-text citations only when needed to support clinical recommendations; avoid extensive bibliographies
-
-Every treatment plan should include clear goals, specific interventions, defined timelines, monitoring parameters, and expected outcomes that align with patient preferences and current clinical guidelines - all presented as efficiently as possible.
-
-## When to Use This Skill
-
-This skill should be used when:
-- Creating individualized treatment plans for patient care
-- Documenting therapeutic interventions for chronic disease management
-- Developing rehabilitation programs (physical therapy, occupational therapy, cardiac rehab)
-- Writing mental health and psychiatric treatment plans
-- Planning perioperative and surgical care pathways
-- Establishing pain management protocols
-- Setting patient-centered goals using SMART criteria
-- Coordinating multidisciplinary care across specialties
-- Ensuring regulatory compliance in treatment documentation
-- Generating professional treatment plans for medical records
-
-## Visual Enhancement with Scientific Schematics
-
-**⚠️ MANDATORY: Every treatment plan MUST include at least 1 AI-generated figure using the scientific-schematics skill.**
-
-This is not optional. Treatment plans benefit greatly from visual elements. Before finalizing any document:
-1. Generate at minimum ONE schematic or diagram (e.g., treatment pathway flowchart, care coordination diagram, or therapy timeline)
-2. For complex plans: include decision algorithm flowchart
-3. For rehabilitation plans: include milestone progression diagram
-
-**How to generate figures:**
-- Use the **scientific-schematics** skill to generate AI-powered publication-quality diagrams
-- Simply describe your desired diagram in natural language
-- Nano Banana Pro will automatically generate, review, and refine the schematic
-
-**How to generate schematics:**
-```bash
-python scripts/generate_schematic.py "your diagram description" -o figures/output.png
-```
-
-The AI will automatically:
-- Create publication-quality images with proper formatting
-- Review and refine through multiple iterations
-- Ensure accessibility (colorblind-friendly, high contrast)
-- Save outputs in the figures/ directory
-
-**When to add schematics:**
-- Treatment pathway flowcharts
-- Care coordination diagrams
-- Therapy progression timelines
-- Multidisciplinary team interaction diagrams
-- Medication management flowcharts
-- Rehabilitation protocol visualizations
-- Clinical decision algorithm diagrams
-- Any complex concept that benefits from visualization
-
-For detailed guidance on creating schematics, refer to the scientific-schematics skill documentation.
-
----
-
-## Document Format and Best Practices
-
-### Document Length Options
-
-Treatment plans come in three format options based on clinical complexity and use case:
-
-#### Option 1: One-Page Treatment Plan (PREFERRED for most cases)
-
-**When to use**: Straightforward clinical scenarios, standard protocols, busy clinical settings
-
-**Format**: Single page containing all essential treatment information in scannable sections
-- No table of contents needed
-- No extensive narratives
-- Focused on actionable items only
-- Similar to precision oncology reports or treatment recommendation cards
-
-**Required sections** (all on one page):
-1. **Header Box**: Patient info, diagnosis, date, molecular/risk profile if applicable
-2. **Treatment Regimen**: Numbered list of specific interventions
-3. **Supportive Care**: Brief bullet points
-4. **Rationale**: 1-2 sentence justification (optional for standard protocols)
-5. **Monitoring**: Key parameters and frequency
-6. **Evidence Level**: Guideline reference or evidence grade (e.g., "Level 1, FDA approved")
-7. **Expected Outcome**: Timeline and success metrics
-
-**Design principles**:
-- Use small boxes/tables for organization (like the clinical treatment recommendation card format)
-- Eliminate all non-essential text
-- Use abbreviations familiar to clinicians
-- Dense information layout - maximize information per square inch
-- Think "quick reference card" not "comprehensive documentation"
-
-**Example structure**:
-```latex
-[Patient ID/Diagnosis Box at top]
-
-TARGET PATIENT POPULATION
-  Number of patients, demographics, key features
-
-PRIMARY TREATMENT REGIMEN
-  • Medication 1: dose, frequency, duration
-  • Procedure: specific details
-  • Monitoring: what and when
-
-SUPPORTIVE CARE
-  • Key supportive medications
-
-RATIONALE
-  Brief clinical justification
-
-MOLECULAR TARGETS / RISK FACTORS
-  Relevant biomarkers or risk stratification
-
-EVIDENCE LEVEL
-  Guideline reference, trial data
-
-MONITORING REQUIREMENTS
-  Key labs/vitals, frequency
-
-EXPECTED CLINICAL BENEFIT
-  Primary endpoint, timeline
-```
-
-#### Option 2: Standard 3-4 Page Format
-
-**When to use**: Moderate complexity, need for patient education materials, multidisciplinary coordination
-
-Uses the Foundation Medicine first-page summary model with 2-3 additional pages of details.
-
-#### Option 3: Extended 5-6 Page Format
-
-**When to use**: Complex comorbidities, research protocols, extensive safety monitoring required
-
-### First Page Summary (Foundation Medicine Model)
-
-**CRITICAL REQUIREMENT: All treatment plans MUST have a complete executive summary on the first page ONLY, before any table of contents or detailed sections.**
-
-Following the Foundation Medicine model for precision medicine reporting and clinical summary documents, treatment plans begin with a one-page executive summary that provides immediate access to key actionable information. This entire summary must fit on the first page.
-
-**Required First Page Structure (in order):**
-
-1. **Title and Subtitle**
-   - Main title: Treatment plan type (e.g., "Comprehensive Treatment Plan")
-   - Subtitle: Specific condition or focus (e.g., "Type 2 Diabetes Mellitus - Young Adult Patient")
-
-2. **Report Information Box** (using `\begin{infobox}` or `\begin{patientinfo}`)
-   - Report type/document purpose
-   - Date of plan creation
-   - Patient demographics (age, sex, de-identified)
-   - Primary diagnosis with ICD-10 code
-   - Report author/clinic (if applicable)
-   - Analysis approach or framework used
-
-3. **Key Findings or Treatment Highlights** (2-4 colored boxes using appropriate box types)
-   - **Primary Treatment Goals** (using `\begin{goalbox}`)
-     - 2-3 SMART goals in bullet format
-   - **Main Interventions** (using `\begin{keybox}` or `\begin{infobox}`)
-     - 2-3 key interventions (pharmacological, non-pharmacological, monitoring)
-   - **Critical Decision Points** (using `\begin{warningbox}` if urgent)
-     - Important monitoring thresholds or safety considerations
-   - **Timeline Overview** (using `\begin{infobox}`)
-     - Brief treatment duration/phases
-     - Key milestone dates
-
-**Visual Format Requirements:**
-- Use `\thispagestyle{empty}` to remove page numbers from first page
-- All content must fit on page 1 (before `\newpage`)
-- Use colored boxes (tcolorbox package) with different colors for different information types
-- Boxes should be visually prominent and easy to scan
-- Use concise, bullet-point format
-- Table of contents (if included) starts on page 2
-- Detailed sections start on page 3
-
-**Example First Page Structure:**
-```latex
-\maketitle
-\thispagestyle{empty}
-
-% Report Information Box
-\begin{patientinfo}
-  Report Type, Date, Patient Info, Diagnosis, etc.
-\end{patientinfo}
-
-% Key Finding #1: Treatment Goals
-\begin{goalbox}[Primary Treatment Goals]
-  • Goal 1
-  • Goal 2
-  • Goal 3
-\end{goalbox}
-
-% Key Finding #2: Main Interventions
-\begin{keybox}[Core Interventions]
-  • Intervention 1
-  • Intervention 2
-  • Intervention 3
-\end{keybox}
-
-% Key Finding #3: Critical Monitoring (if applicable)
-\begin{warningbox}[Critical Decision Points]
-  • Decision point 1
-  • Decision point 2
-\end{warningbox}
-
-\newpage
-\tableofcontents  % TOC on page 2
-\newpage  % Detailed content starts page 3
-```
-
-### Concise Documentation
-
-**CRITICAL: Treatment plans MUST prioritize brevity and clinical relevance. Default to 3-4 pages maximum unless clinical complexity absolutely demands more detail.**
-
-Treatment plans should prioritize **clarity and actionability** over exhaustive detail:
-
-- **Focused**: Include only clinically essential information that impacts care decisions
-- **Actionable**: Emphasize what needs to be done, when, and why
-- **Efficient**: Facilitate quick decision-making without sacrificing clinical quality
-- **Target length options**:
-  - **1-page format** (preferred for straightforward cases): Quick-reference card with all essential information
-  - **3-4 pages standard**: Standard format with first-page summary + supporting details
-  - **5-6 pages** (rare): Only for highly complex cases with multiple comorbidities or multidisciplinary interventions
-
-**Streamlining Guidelines:**
-- **First Page Summary**: Use individual colored boxes to consolidate key information (goals, interventions, decision points) - this alone can often convey the essential treatment plan
-- **Eliminate Redundancy**: If information is in the first-page summary, don't repeat it verbatim in detailed sections
-- **Patient Education section**: 3-5 key bullet points on critical topics and warning signs only
-- **Risk Mitigation section**: Highlight only critical medication safety concerns and emergency actions (not exhaustive lists)
-- **Expected Outcomes section**: 2-3 concise statements on anticipated responses and timelines
-- **Interventions**: Focus on primary interventions; secondary/supportive measures in brief bullet format
-- **Use tables and bullet points** extensively for efficient presentation
-- **Avoid narrative prose** where structured lists suffice
-- **Combine related sections** when appropriate to reduce page count
-
-### Quality Over Quantity
-
-The goal is professional, clinically complete documentation that respects clinicians' time while ensuring comprehensive patient care. Every section should add value; remove or condense sections that don't directly inform treatment decisions.
-
-### Citations and Evidence Support
-
-**Use minimal, targeted citations to support clinical recommendations:**
-
-- **Text Citations Preferred**: Use brief in-text citations (Author Year) or simple references rather than extensive bibliographies unless specifically requested
-- **When to Cite**:
-  - Clinical practice guideline recommendations (e.g., "per ADA 2024 guidelines")
-  - Specific medication dosing or protocols (e.g., "ACC/AHA recommendations")
-  - Novel or controversial interventions requiring evidence support
-  - Risk stratification tools or validated assessment scales
-- **When NOT to Cite**:
-  - Standard-of-care interventions widely accepted in the field
-  - Basic medical facts and routine clinical practices
-  - General patient education content
-- **Citation Format**: 
-  - Inline: "Initiate metformin as first-line therapy (ADA Standards of Care 2024)"
-  - Minimal: "Treatment follows ACC/AHA heart failure guidelines"
-  - Avoid formal numbered references and extensive bibliography sections unless document is for academic/research purposes
-- **Keep it Brief**: A 3-4 page treatment plan should have 0-3 citations maximum, only where essential for clinical credibility or novel recommendations
-
-## Core Capabilities
-
-### 1. General Medical Treatment Plans
-
-General medical treatment plans address common chronic conditions and acute medical issues requiring structured therapeutic interventions.
-
-#### Standard Components
-
-**Patient Information (De-identified)**
-- Demographics (age, sex, relevant medical background)
-- Active medical conditions and comorbidities
-- Current medications and allergies
-- Relevant social and family history
-- Functional status and baseline assessments
-- **HIPAA Compliance**: Remove all 18 identifiers per Safe Harbor method
-
-**Diagnosis and Assessment Summary**
-- Primary diagnosis with ICD-10 code
-- Secondary diagnoses and comorbidities
-- Severity classification and staging
-- Functional limitations and quality of life impact
-- Risk stratification (e.g., cardiovascular risk, fall risk)
-- Prognostic indicators
-
-**Treatment Goals (SMART Format)**
-
-Short-term goals (1-3 months):
-- **Specific**: Clearly defined outcome (e.g., "Reduce HbA1c to <7%")
-- **Measurable**: Quantifiable metrics (e.g., "Decrease systolic BP by 10 mmHg")
-- **Achievable**: Realistic given patient capabilities
-- **Relevant**: Aligned with patient priorities and values
-- **Time-bound**: Specific timeframe (e.g., "within 8 weeks")
-
-Long-term goals (6-12 months):
-- Disease control or remission targets
-- Functional improvement objectives
-- Quality of life enhancement
-- Prevention of complications
-- Maintenance of independence
-
-**Interventions**
-
-*Pharmacological*:
-- Medications with specific dosages, routes, frequencies
-- Titration schedules and target doses
-- Drug-drug interaction considerations
-- Monitoring for adverse effects
-- Medication reconciliation
-
-*Non-pharmacological*:
-- Lifestyle modifications (diet, exercise, smoking cessation)
-- Behavioral interventions
-- Patient education and self-management
-- Monitoring and self-tracking (glucose, blood pressure, weight)
-- Assistive devices or adaptive equipment
-
-*Procedural*:
-- Planned procedures or interventions
-- Referrals to specialists
-- Diagnostic testing schedule
-- Preventive care (vaccinations, screenings)
-
-**Timeline and Schedule**
-- Treatment phases with specific timeframes
-- Appointment frequency (weekly, monthly, quarterly)
-- Milestone assessments and goal evaluations
-- Medication adjustments schedule
-- Expected duration of treatment
-
-**Monitoring Parameters**
-- Clinical outcomes to track (vital signs, lab values, symptoms)
-- Assessment tools and scales (e.g., PHQ-9, pain scales)
-- Frequency of monitoring
-- Thresholds for intervention or escalation
-- Patient-reported outcomes
-
-**Expected Outcomes**
-- Primary outcome measures
-- Success criteria and benchmarks
-- Expected timeline for improvement
-- Criteria for treatment modification
-- Long-term prognosis
-
-**Follow-up Plan**
-- Scheduled appointments and reassessments
-- Communication plan (phone calls, secure messaging)
-- Emergency contact procedures
-- Criteria for urgent evaluation
-- Transition or discharge planning
-
-**Patient Education**
-- Understanding of condition and treatment rationale
-- Self-management skills training
-- Medication administration and adherence
-- Warning signs and when to seek help
-- Resources and support services
-
-**Risk Mitigation**
-- Potential adverse effects and management
-- Drug interactions and contraindications
-- Fall prevention, infection prevention
-- Emergency action plans
-- Safety monitoring
-
-#### Common Applications
-
-- Diabetes mellitus management
-- Hypertension control
-- Heart failure treatment
-- COPD management
-- Asthma care plans
-- Hyperlipidemia treatment
-- Osteoarthritis management
-- Chronic kidney disease
-
-### 2. Rehabilitation Treatment Plans
-
-Rehabilitation plans focus on restoring function, improving mobility, and enhancing quality of life through structured therapeutic programs.
-
-#### Core Components
-
-**Functional Assessment**
-- Baseline functional status (ADLs, IADLs)
-- Range of motion, strength, balance, endurance
-- Gait analysis and mobility assessment
-- Standardized measures (FIM, Barthel Index, Berg Balance Scale)
-- Environmental assessment (home safety, accessibility)
-
-**Rehabilitation Goals**
-
-*Impairment-level goals*:
-- Improve shoulder flexion to 140 degrees
-- Increase quadriceps strength by 2/5 MMT grades
-- Enhance balance (Berg Score >45/56)
-
-*Activity-level goals*:
-- Independent ambulation 150 feet with assistive device
-- Climb 12 stairs with handrail supervision
-- Transfer bed-to-chair independently
-
-*Participation-level goals*:
-- Return to work with modifications
-- Resume recreational activities
-- Independent community mobility
-
-**Therapeutic Interventions**
-
-*Physical Therapy*:
-- Therapeutic exercises (strengthening, stretching, endurance)
-- Manual therapy techniques
-- Gait training and balance activities
-- Modalities (heat, ice, electrical stimulation, ultrasound)
-- Assistive device training
-
-*Occupational Therapy*:
-- ADL training (bathing, dressing, grooming, feeding)
-- Upper extremity strengthening and coordination
-- Adaptive equipment and modifications
-- Energy conservation techniques
-- Cognitive rehabilitation
-
-*Speech-Language Pathology*:
-- Swallowing therapy and dysphagia management
-- Communication strategies and augmentative devices
-- Cognitive-linguistic therapy
-- Voice therapy
-
-*Other Services*:
-- Recreational therapy
-- Aquatic therapy
-- Cardiac rehabilitation
-- Pulmonary rehabilitation
-- Vestibular rehabilitation
-
-**Treatment Schedule**
-- Frequency: 3x/week PT, 2x/week OT (example)
-- Session duration: 45-60 minutes
-- Treatment phase durations (acute, subacute, maintenance)
-- Expected total duration: 8-12 weeks
-- Reassessment intervals
-
-**Progress Monitoring**
-- Weekly functional assessments
-- Standardized outcome measures
-- Goal attainment scaling
-- Pain and symptom tracking
-- Patient satisfaction
-
-**Home Exercise Program**
-- Specific exercises with repetitions/sets/frequency
-- Precautions and safety instructions
-- Progression criteria
-- Self-monitoring strategies
-
-#### Specialty Rehabilitation
-
-- Post-stroke rehabilitation
-- Orthopedic rehabilitation (joint replacement, fracture)
-- Cardiac rehabilitation (post-MI, post-surgery)
-- Pulmonary rehabilitation
-- Vestibular rehabilitation
-- Neurological rehabilitation
-- Sports injury rehabilitation
-
-### 3. Mental Health Treatment Plans
-
-Mental health treatment plans address psychiatric conditions through integrated psychotherapeutic, pharmacological, and psychosocial interventions.
-
-#### Essential Components
-
-**Psychiatric Assessment**
-- Primary psychiatric diagnosis (DSM-5 criteria)
-- Symptom severity and functional impairment
-- Co-occurring mental health conditions
-- Substance use assessment
-- Suicide/homicide risk assessment
-- Trauma history and PTSD screening
-- Social determinants of mental health
-
-**Treatment Goals**
-
-*Symptom reduction*:
-- Decrease depression severity (PHQ-9 score from 18 to <10)
-- Reduce anxiety symptoms (GAD-7 score <5)
-- Improve sleep quality (Pittsburgh Sleep Quality Index)
-- Stabilize mood (reduced mood episodes)
-
-*Functional improvement*:
-- Return to work or school
-- Improve social relationships and support
-- Enhance coping skills and emotional regulation
-- Increase engagement in meaningful activities
-
-*Recovery-oriented goals*:
-- Build resilience and self-efficacy
-- Develop crisis management skills
-- Establish sustainable wellness routines
-- Achieve personal recovery goals
-
-**Therapeutic Interventions**
-
-*Psychotherapy*:
-- Evidence-based modality (CBT, DBT, ACT, psychodynamic, IPT)
-- Session frequency (weekly, biweekly)
-- Treatment duration (12-16 weeks, ongoing)
-- Specific techniques and targets
-- Group therapy participation
-
-*Psychopharmacology*:
-- Medication class and rationale
-- Starting dose and titration schedule
-- Target symptoms
-- Expected response timeline (2-4 weeks for antidepressants)
-- Side effect monitoring
-- Combination therapy considerations
-
-*Psychosocial Interventions*:
-- Case management services
-- Peer support programs
-- Family therapy or psychoeducation
-- Vocational rehabilitation
-- Supported housing or community integration
-- Substance abuse treatment
-
-**Safety Planning**
-- Crisis contacts and emergency services
-- Warning signs and triggers
-- Coping strategies and self-soothing techniques
-- Safe environment modifications
-- Means restriction (firearms, medications)
-- Support system activation
-
-**Monitoring and Assessment**
-- Symptom rating scales (weekly or biweekly)
-- Medication adherence and side effects
-- Suicidal ideation screening
-- Functional status assessments
-- Treatment engagement and therapeutic alliance
-
-**Patient and Family Education**
-- Psychoeducation about diagnosis
-- Treatment rationale and expectations
-- Medication information
-- Relapse prevention strategies
-- Community resources
-
-#### Mental Health Conditions
-
-- Major depressive disorder
-- Anxiety disorders (GAD, panic, social anxiety)
-- Bipolar disorder
-- Schizophrenia and psychotic disorders
-- PTSD and trauma-related disorders
-- Eating disorders
-- Substance use disorders
-- Personality disorders
-
-### 4. Chronic Disease Management Plans
-
-Comprehensive long-term care plans for chronic conditions requiring ongoing monitoring, treatment adjustments, and multidisciplinary coordination.
-
-#### Key Features
-
-**Disease-Specific Targets**
-- Evidence-based treatment goals per guidelines
-- Stage-appropriate interventions
-- Complication prevention strategies
-- Disease progression monitoring
-
-**Self-Management Support**
-- Patient activation and engagement
-- Shared decision-making
-- Action plans for symptom changes
-- Technology-enabled monitoring (apps, remote monitoring)
-
-**Care Coordination**
-- Primary care physician oversight
-- Specialist consultations and co-management
-- Care transitions (hospital to home)
-- Medication management across providers
-- Communication protocols
-
-**Population Health Integration**
-- Registry tracking and outreach
-- Preventive care and screening schedules
-- Quality measure reporting
-- Care gaps identification
-
-#### Applicable Conditions
-
-- Type 1 and Type 2 diabetes
-- Cardiovascular disease (CHF, CAD)
-- Chronic respiratory diseases (COPD, asthma)
-- Chronic kidney disease
-- Inflammatory bowel disease
-- Rheumatoid arthritis and autoimmune conditions
-- HIV/AIDS
-- Cancer survivorship care
-
-### 5. Perioperative Care Plans
-
-Structured plans for surgical and procedural patients covering preoperative preparation, intraoperative management, and postoperative recovery.
-
-#### Components
-
-**Preoperative Assessment**
-- Surgical indication and planned procedure
-- Preoperative risk stratification (ASA class, cardiac risk)
-- Optimization of medical conditions
-- Medication management (continuation, discontinuation)
-- Preoperative testing and clearances
-- Informed consent and patient education
-
-**Perioperative Interventions**
-- Enhanced recovery after surgery (ERAS) protocols
-- Venous thromboembolism prophylaxis
-- Antibiotic prophylaxis
-- Glycemic control strategies
-- Pain management plan (multimodal analgesia)
-
-**Postoperative Care**
-- Immediate recovery goals (24-48 hours)
-- Early mobilization protocols
-- Diet advancement
-- Wound care and drain management
-- Pain control regimen
-- Complication monitoring
-
-**Discharge Planning**
-- Activity restrictions and progression
-- Medication reconciliation
-- Follow-up appointments
-- Home health or rehabilitation services
-- Return-to-work timeline
-
-### 6. Pain Management Plans
-
-Multimodal approaches to acute and chronic pain using evidence-based interventions and opioid-sparing strategies.
-
-#### Comprehensive Components
-
-**Pain Assessment**
-- Pain location, quality, intensity (0-10 scale)
-- Temporal pattern (constant, intermittent, breakthrough)
-- Aggravating and alleviating factors
-- Functional impact (sleep, activities, mood)
-- Previous treatments and responses
-- Psychosocial contributors
-
-**Multimodal Interventions**
-
-*Pharmacological*:
-- Non-opioid analgesics (acetaminophen, NSAIDs)
-- Adjuvant medications (antidepressants, anticonvulsants, muscle relaxants)
-- Topical agents (lidocaine, capsaicin, diclofenac)
-- Opioid therapy (when appropriate, with risk mitigation)
-- Titration and rotation strategies
-
-*Interventional Procedures*:
-- Nerve blocks and injections
-- Radiofrequency ablation
-- Spinal cord stimulation
-- Intrathecal drug delivery
-
-*Non-pharmacological*:
-- Physical therapy and exercise
-- Cognitive-behavioral therapy for pain
-- Mindfulness and relaxation techniques
-- Acupuncture
-- TENS units
-
-**Opioid Safety (when prescribed)**
-- Indication and planned duration
-- Prescription drug monitoring program (PDMP) check
-- Opioid risk assessment tools
-- Naloxone prescription
-- Treatment agreements
-- Random urine drug screening
-- Frequent follow-up and reassessment
-
-**Functional Goals**
-- Specific activity improvements
-- Sleep quality enhancement
-- Reduced pain interference
-- Improved quality of life
-- Return to work or meaningful activities
-
-## Best Practices
-
-### Brevity and Focus (HIGHEST PRIORITY)
-
-**Treatment plans MUST be concise and focused on actionable clinical information:**
-
-- **1-page format is PREFERRED**: For most clinical scenarios, a single-page treatment plan (like precision oncology reports) provides all necessary information
-- **Default to shortest format possible**: Start with 1-page; only expand if clinical complexity genuinely requires it
-- **Every sentence must add value**: If a section doesn't change clinical decision-making, omit it entirely
-- **Think "quick reference card" not "comprehensive textbook"**: Busy clinicians need scannable, dense information
-- **Avoid academic verbosity**: This is clinical documentation, not a literature review or teaching document
-- **Maximum lengths by complexity**:
-  - Simple/standard cases: 1 page
-  - Moderate complexity: 3-4 pages (first-page summary + details)
-  - High complexity (rare): 5-6 pages maximum
-
-### First Page Summary (Most Important)
-
-**ALWAYS create a one-page executive summary as the first page:**
-- The first page must contain ONLY: Title, Report Info Box, and Key Findings boxes
-- This provides an at-a-glance overview similar to precision medicine reports
-- Table of contents and detailed sections start on page 2 or later
-- Think of it as a "clinical highlights" page that a busy clinician can scan in 30 seconds
-- Use 2-4 colored boxes for different key findings (goals, interventions, decision points)
-- **A strong first page can often stand alone** - subsequent pages are for details, not repetition
-
-### SMART Goal Setting
-
-All treatment goals should meet SMART criteria:
-
-- **Specific**: "Improve HbA1c to <7%" not "Better diabetes control"
-- **Measurable**: Use quantifiable metrics, validated scales, objective measures
-- **Achievable**: Consider patient capabilities, resources, social support
-- **Relevant**: Align with patient values, priorities, and life circumstances
-- **Time-bound**: Define clear timeframes for goal achievement and reassessment
-
-### Patient-Centered Care
-
-✓ **Shared Decision-Making**: Involve patients in goal-setting and treatment choices  
-✓ **Cultural Competence**: Respect cultural beliefs, language preferences, health literacy  
-✓ **Patient Preferences**: Honor treatment preferences and personal values  
-✓ **Individualization**: Tailor plans to patient's unique circumstances  
-✓ **Empowerment**: Support patient activation and self-management  
-
-### Evidence-Based Practice
-
-✓ **Clinical Guidelines**: Follow current specialty society recommendations  
-✓ **Quality Measures**: Incorporate HEDIS, CMS quality measures  
-✓ **Comparative Effectiveness**: Use treatments with proven efficacy  
-✓ **Avoid Low-Value Care**: Eliminate unnecessary tests and interventions  
-✓ **Stay Current**: Update plans based on emerging evidence  
-
-### Documentation Standards
-
-✓ **Completeness**: Include all required elements  
-✓ **Clarity**: Use clear, professional medical language  
-✓ **Accuracy**: Ensure factual correctness and current information  
-✓ **Timeliness**: Document plans promptly  
-✓ **Legibility**: Professional formatting and organization  
-✓ **Signature and Date**: Authenticate all treatment plans  
-
-### Regulatory Compliance
-
-✓ **HIPAA Privacy**: De-identify all protected health information  
-✓ **Informed Consent**: Document patient understanding and agreement  
-✓ **Billing Support**: Include documentation to support medical necessity  
-✓ **Quality Reporting**: Enable extraction of quality metrics  
-✓ **Legal Protection**: Maintain defensible clinical documentation  
-
-### Multidisciplinary Coordination
-
-✓ **Team Communication**: Share plans across care team  
-✓ **Role Clarity**: Define responsibilities for each team member  
-✓ **Care Transitions**: Ensure continuity across settings  
-✓ **Specialist Integration**: Coordinate with subspecialty care  
-✓ **Patient-Centered Medical Home**: Align with PCMH principles  
-
-## LaTeX Template Usage
-
-### Template Selection
-
-Choose the appropriate template based on clinical context and desired length:
-
-#### Concise Templates (PREFERRED)
-
-1. **one_page_treatment_plan.tex** - **FIRST CHOICE** for most cases
-   - All clinical specialties
-   - Standard protocols and straightforward cases
-   - Quick-reference format similar to precision oncology reports
-   - Dense, scannable, clinician-focused
-   - Use this unless complexity demands more detail
-
-#### Standard Templates (3-4 pages)
-
-Use only when one-page format is insufficient due to complexity:
-
-2. **general_medical_treatment_plan.tex** - Primary care, chronic disease, general medicine
-3. **rehabilitation_treatment_plan.tex** - PT/OT, post-surgery, injury recovery
-4. **mental_health_treatment_plan.tex** - Psychiatric conditions, behavioral health
-5. **chronic_disease_management_plan.tex** - Complex chronic diseases, multiple conditions
-6. **perioperative_care_plan.tex** - Surgical patients, procedural care
-7. **pain_management_plan.tex** - Acute or chronic pain conditions
-
-**Note**: Even when using standard templates, adapt them to be concise (3-4 pages max) by removing non-essential sections.
-
-### Template Structure
-
-All LaTeX templates include:
-- Professional formatting with appropriate margins and fonts
-- Structured sections for all required components
-- Tables for medications, interventions, timelines
-- Goal-tracking sections with SMART criteria
-- Space for provider signatures and dates
-- HIPAA-compliant de-identification guidance
-- Comments with detailed instructions
-
-### Generating PDFs
-
-```bash
-# Compile LaTeX template to PDF
-pdflatex general_medical_treatment_plan.tex
-
-# For templates with references
-pdflatex treatment_plan.tex
-bibtex treatment_plan
-pdflatex treatment_plan.tex
-pdflatex treatment_plan.tex
-```
-
-## Validation and Quality Assurance
-
-### Completeness Checking
-
-Use validation scripts to ensure all required sections are present:
-
-```bash
-python check_completeness.py my_treatment_plan.tex
-```
-
-The script checks for:
-- Patient information section
-- Diagnosis and assessment
-- SMART goals (short-term and long-term)
-- Interventions (pharmacological, non-pharmacological)
-- Timeline and schedule
-- Monitoring parameters
-- Expected outcomes
-- Follow-up plan
-- Patient education
-- Risk mitigation
-
-### Treatment Plan Validation
-
-Comprehensive validation of treatment plan quality:
-
-```bash
-python validate_treatment_plan.py my_treatment_plan.tex
-```
-
-Validation includes:
-- SMART goal criteria assessment
-- Evidence-based intervention verification
-- Timeline feasibility check
-- Monitoring parameter adequacy
-- Safety and risk mitigation review
-- Regulatory compliance check
-
-### Quality Checklist
-
-Review treatment plans against the quality checklist (`quality_checklist.md`):
-
-**Clinical Quality**
-- [ ] Diagnosis is accurate and properly coded (ICD-10)
-- [ ] Goals are SMART and patient-centered
-- [ ] Interventions are evidence-based and guideline-concordant
-- [ ] Timeline is realistic and clearly defined
-- [ ] Monitoring plan is comprehensive
-- [ ] Safety considerations are addressed
-
-**Patient-Centered Care**
-- [ ] Patient preferences and values incorporated
-- [ ] Shared decision-making documented
-- [ ] Health literacy appropriate language
-- [ ] Cultural considerations addressed
-- [ ] Patient education plan included
-
-**Regulatory Compliance**
-- [ ] HIPAA-compliant de-identification
-- [ ] Medical necessity documented
-- [ ] Informed consent noted
-- [ ] Provider signature and credentials
-- [ ] Date of plan creation/revision
-
-**Coordination and Communication**
-- [ ] Specialist referrals documented
-- [ ] Care team roles defined
-- [ ] Follow-up schedule clear
-- [ ] Emergency contacts provided
-- [ ] Transition planning addressed
-
-## Integration with Other Skills
-
-### Clinical Reports Integration
-
-Treatment plans often accompany other clinical documentation:
-
-- **SOAP Notes** (`clinical-reports` skill): Document ongoing implementation
-- **H&P** (`clinical-reports` skill): Initial assessment informs treatment plan
-- **Discharge Summaries** (`clinical-reports` skill): Summarize treatment plan execution
-- **Progress Notes**: Track goal achievement and plan modifications
-
-### Scientific Writing Integration
-
-Evidence-based treatment planning requires literature support:
-
-- **Citation Management** (`citation-management` skill): Reference clinical guidelines
-- **Literature Review** (`literature-review` skill): Understand treatment evidence base
-- **Research Lookup** (`research-lookup` skill): Find current best practices
-- **Venue Templates** (`venue-templates` skill): For publication-ready medical writing style
-
-**Medical Writing Style:** When preparing treatment-related content for publication (case reports, clinical guidelines), consult the venue-templates skill's `medical_journal_styles.md` for guidance on evidence-graded language, patient-centered terminology, and structured abstract formats used in NEJM, Lancet, JAMA, and BMJ.
-
-### Research Integration
-
-Treatment plans may be developed for clinical trials or research studies:
-
-- **Research Grants** (`research-grants` skill): Treatment protocols for funded studies
-- **Clinical Trial Reports** (`clinical-reports` skill): Intervention documentation
-
-## Common Use Cases
-
-### Example 1: Type 2 Diabetes Management
-
-**Scenario**: 58-year-old patient with newly diagnosed Type 2 diabetes, HbA1c 8.5%, BMI 32
-
-**Template**: `general_medical_treatment_plan.tex`
-
-**Goals**:
-- Short-term: Reduce HbA1c to <7.5% in 3 months
-- Long-term: Achieve HbA1c <7%, lose 15 pounds in 6 months
-
-**Interventions**:
-- Pharmacological: Metformin 500mg BID, titrate to 1000mg BID
-- Lifestyle: Mediterranean diet, 150 min/week moderate exercise
-- Education: Diabetes self-management education, glucose monitoring
-
-### Example 2: Post-Stroke Rehabilitation
-
-**Scenario**: 70-year-old patient s/p left MCA stroke with right hemiparesis
-
-**Template**: `rehabilitation_treatment_plan.tex`
-
-**Goals**:
-- Short-term: Improve right arm strength 2/5 to 3/5 in 4 weeks
-- Long-term: Independent ambulation 150 feet with cane in 12 weeks
-
-**Interventions**:
-- PT 3x/week: Gait training, balance, strengthening
-- OT 3x/week: ADL training, upper extremity function
-- SLP 2x/week: Dysphagia therapy
-
-### Example 3: Major Depressive Disorder
-
-**Scenario**: 35-year-old with moderate depression, PHQ-9 score 16
-
-**Template**: `mental_health_treatment_plan.tex`
-
-**Goals**:
-- Short-term: Reduce PHQ-9 to <10 in 8 weeks
-- Long-term: Achieve remission (PHQ-9 <5), return to work
-
-**Interventions**:
-- Psychotherapy: CBT weekly sessions
-- Medication: Sertraline 50mg daily, titrate to 100mg
-- Lifestyle: Sleep hygiene, exercise 30 min 5x/week
-
-### Example 4: Total Knee Arthroplasty
-
-**Scenario**: 68-year-old scheduled for right TKA for osteoarthritis
-
-**Template**: `perioperative_care_plan.tex`
-
-**Preoperative Goals**:
-- Optimize diabetes control (glucose <180)
-- Discontinue anticoagulation per protocol
-- Complete medical clearance
-
-**Postoperative Goals**:
-- Ambulate 50 feet by POD 1
-- 90-degree knee flexion by POD 3
-- Discharge home with PT services by POD 2-3
-
-### Example 5: Chronic Low Back Pain
-
-**Scenario**: 45-year-old with chronic non-specific low back pain, pain 7/10
-
-**Template**: `pain_management_plan.tex`
-
-**Goals**:
-- Short-term: Reduce pain to 4/10 in 6 weeks
-- Long-term: Return to work full-time, pain 2-3/10
-
-**Interventions**:
-- Pharmacological: Gabapentin 300mg TID, duloxetine 60mg daily
-- PT: Core strengthening, McKenzie exercises 2x/week x 8 weeks
-- Behavioral: CBT for pain, mindfulness meditation
-- Interventional: Consider lumbar ESI if inadequate response
-
-## Professional Standards and Guidelines
-
-Treatment plans should align with:
-
-### 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 Clinical Practice Guidelines
-- AOTA Practice Guidelines
-- Cardiac Rehabilitation Guidelines (AHA/AACVPR)
-- Stroke Rehabilitation Guidelines
-
-### Mental Health
-- APA Practice Guidelines
-- VA/DoD Clinical Practice Guidelines
-- NICE Guidelines (National Institute for Health and Care Excellence)
-- Cochrane Reviews for psychiatric interventions
-
-### Pain Management
-- CDC Opioid Prescribing Guidelines
-- AAPM/APS Chronic Pain Guidelines
-- WHO Pain Ladder
-- Multimodal Analgesia Best Practices
-
-## Timeline Generation
-
-Use the timeline generator script to create visual treatment timelines:
-
-```bash
-python timeline_generator.py --plan my_treatment_plan.tex --output timeline.pdf
-```
-
-Generates:
-- Gantt chart of treatment phases
-- Milestone markers for goal assessments
-- Medication titration schedules
-- Follow-up appointment calendar
-- Intervention intensity over time
-
-## Support and Resources
-
-### Template Generation
-
-Interactive template selection:
-
-```bash
-cd .claude/skills/treatment-plans/scripts
-python generate_template.py
-
-# Or specify type directly
-python generate_template.py --type mental_health --output depression_treatment_plan.tex
-```
-
-### Validation Workflow
-
-1. **Create treatment plan** using appropriate LaTeX template
-2. **Check completeness**: `python check_completeness.py plan.tex`
-3. **Validate quality**: `python validate_treatment_plan.py plan.tex`
-4. **Review checklist**: Compare against `quality_checklist.md`
-5. **Generate PDF**: `pdflatex plan.tex`
-6. **Review with patient**: Ensure understanding and agreement
-7. **Implement and document**: Track progress in clinical notes
-
-### Additional Resources
-
-- Clinical practice guidelines from specialty societies
-- AHRQ Effective Health Care Program
-- Cochrane Library for intervention evidence
-- UpToDate and DynaMed for treatment recommendations
-- CMS Quality Measures and HEDIS specifications
-
-## Professional Document Styling
-
-### Overview
-
-Treatment plans can be enhanced with professional medical document styling using the `medical_treatment_plan.sty` LaTeX package. This custom style transforms plain academic documents into visually appealing, color-coded clinical documents that maintain scientific rigor while improving readability and usability.
-
-### Medical Treatment Plan Style Package
-
-The `medical_treatment_plan.sty` package (located in `assets/medical_treatment_plan.sty`) provides:
-
-**Professional Color Scheme**
-- **Primary Blue** (RGB: 0, 102, 153): Headers, section titles, primary accents
-- **Secondary Blue** (RGB: 102, 178, 204): Light backgrounds, subtle accents
-- **Accent Blue** (RGB: 0, 153, 204): Hyperlinks, key highlights
-- **Success Green** (RGB: 0, 153, 76): Goals, positive outcomes
-- **Warning Red** (RGB: 204, 0, 0): Warnings, critical information
-- **Dark Gray** (RGB: 64, 64, 64): Body text
-- **Light Gray** (RGB: 245, 245, 245): Background fills
-
-**Styled Elements**
-- Custom colored headers and footers with professional rules
-- Blue section titles with underlines for clear hierarchy
-- Enhanced table formatting with colored headers and alternating rows
-- Optimized list spacing with colored bullets and numbering
-- Professional page layout with appropriate margins
-
-### Custom Information Boxes
-
-The style package includes five specialized box environments for organizing clinical information:
-
-#### 1. Info Box (Blue Border, Light Gray Background)
-
-For general information, clinical assessments, and testing schedules:
-
-```latex
-\begin{infobox}[Title]
-  \textbf{Key Information:}
-  \begin{itemize}
-    \item Clinical assessment details
-    \item Testing schedules
-    \item General guidance
-  \end{itemize}
-\end{infobox}
-```
-
-**Use cases**: Metabolic status, baseline assessments, monitoring schedules, titration protocols
-
-#### 2. Warning Box (Red Border, Yellow Background)
-
-For critical decision points, safety protocols, and alerts:
-
-```latex
-\begin{warningbox}[Alert Title]
-  \textbf{Important Safety Information:}
-  \begin{itemize}
-    \item Critical drug interactions
-    \item Safety monitoring requirements
-    \item Red flag symptoms requiring immediate action
-  \end{itemize}
-\end{warningbox}
-```
-
-**Use cases**: Medication safety, decision points, contraindications, emergency protocols
-
-#### 3. Goal Box (Green Border, Green-Tinted Background)
-
-For treatment goals, targets, and success criteria:
-
-```latex
-\begin{goalbox}[Treatment Goals]
-  \textbf{Primary Objectives:}
-  \begin{itemize}
-    \item Reduce HbA1c to <7\% within 3 months
-    \item Achieve 5-7\% weight loss in 12 weeks
-    \item Complete diabetes education program
-  \end{itemize}
-\end{goalbox}
-```
-
-**Use cases**: SMART goals, target outcomes, success metrics, CGM goals
-
-#### 4. Key Points Box (Blue Background)
-
-For executive summaries, key takeaways, and important recommendations:
-
-```latex
-\begin{keybox}[Key Highlights]
-  \textbf{Essential Points:}
-  \begin{itemize}
-    \item Main therapeutic approach
-    \item Critical patient instructions
-    \item Priority interventions
-  \end{itemize}
-\end{keybox}
-```
-
-**Use cases**: Plan overview, plate method instructions, important dietary guidelines
-
-#### 5. Emergency Box (Large Red Design)
-
-For emergency contacts and urgent protocols:
-
-```latex
-\begin{emergencybox}
-  \begin{itemize}
-    \item \textbf{Emergency Services:} 911
-    \item \textbf{Endocrinology Office:} [Phone] (business hours)
-    \item \textbf{After-Hours Hotline:} [Phone] (nights/weekends)
-    \item \textbf{Pharmacy:} [Phone and location]
-  \end{itemize}
-\end{emergencybox}
-```
-
-**Use cases**: Emergency contacts, critical hotlines, urgent resource information
-
-#### 6. Patient Info Box (White with Blue Border)
-
-For patient demographics and baseline information:
-
-```latex
-\begin{patientinfo}
-  \begin{tabular}{ll}
-    \textbf{Age:} & 23 years \\
-    \textbf{Sex:} & Male \\
-    \textbf{Diagnosis:} & Type 2 Diabetes Mellitus \\
-    \textbf{Plan Start Date:} & \today \\
-  \end{tabular}
-\end{patientinfo}
-```
-
-**Use cases**: Patient information sections, demographic data
-
-### Professional Table Formatting
-
-Enhanced table environment with medical styling:
-
-```latex
-\begin{medtable}{Caption Text}
-\begin{tabular}{|p{5cm}|p{4cm}|p{4.5cm}|}
-\hline
-\tableheadercolor  % Blue header with white text
-\textcolor{white}{\textbf{Column 1}} & 
-\textcolor{white}{\textbf{Column 2}} & 
-\textcolor{white}{\textbf{Column 3}} \\
-\hline
-Data row 1 content & Value 1 & Details 1 \\
-\hline
-\tablerowcolor  % Alternating light gray row
-Data row 2 content & Value 2 & Details 2 \\
-\hline
-Data row 3 content & Value 3 & Details 3 \\
-\hline
-\end{tabular}
-\caption{Table caption}
-\end{medtable}
-```
-
-**Features:**
-- Blue headers with white text for visual prominence
-- Alternating row colors (`\tablerowcolor`) for improved readability
-- Automatic centering and spacing
-- Professional borders and padding
-
-### Using the Style Package
-
-#### Basic Setup
-
-1. **Add to document preamble:**
-
-```latex
-% !TEX program = xelatex
-\documentclass[11pt,letterpaper]{article}
-
-% Use custom medical treatment plan style
-\usepackage{medical_treatment_plan}
-\usepackage{natbib}
-
-\begin{document}
-\maketitle
-% Your content here
-\end{document}
-```
-
-2. **Ensure style file is in same directory** as your `.tex` file, or install to LaTeX path
-
-3. **Compile with XeLaTeX** (recommended for best results):
-
-```bash
-xelatex treatment_plan.tex
-bibtex treatment_plan
-xelatex treatment_plan.tex
-xelatex treatment_plan.tex
-```
-
-#### Custom Title Page
-
-The package automatically formats the title with a professional blue header:
-
-```latex
-\title{\textbf{Individualized Diabetes Treatment Plan}\\
-\large{23-Year-Old Male Patient with Type 2 Diabetes}}
-\author{Comprehensive Care Plan}
-\date{\today}
-
-\begin{document}
-\maketitle
-```
-
-This creates an eye-catching blue box with white text and clear hierarchy.
-
-### Compilation Requirements
-
-**Required LaTeX Packages** (automatically loaded by the style):
-- `geometry` - Page layout and margins
-- `xcolor` - Color support
-- `tcolorbox` with `[most]` library - Custom colored boxes
-- `tikz` - Graphics and drawing
-- `fontspec` - Font management (XeLaTeX/LuaLaTeX)
-- `fancyhdr` - Custom headers and footers
-- `titlesec` - Section styling
-- `enumitem` - Enhanced list formatting
-- `booktabs` - Professional table rules
-- `longtable` - Multi-page tables
-- `array` - Enhanced table features
-- `colortbl` - Colored table cells
-- `hyperref` - Hyperlinks and PDF metadata
-- `natbib` - Bibliography management
-
-**Recommended Compilation:**
-
-```bash
-# Using XeLaTeX (best font support)
-xelatex document.tex
-bibtex document
-xelatex document.tex
-xelatex document.tex
-
-# Using PDFLaTeX (alternative)
-pdflatex document.tex
-bibtex document
-pdflatex document.tex
-pdflatex document.tex
-```
-
-### Customization Options
-
-#### Changing Colors
-
-Edit the style file to modify the color scheme:
-
-```latex
-% In medical_treatment_plan.sty
-\definecolor{primaryblue}{RGB}{0, 102, 153}      % Modify these
-\definecolor{secondaryblue}{RGB}{102, 178, 204}
-\definecolor{accentblue}{RGB}{0, 153, 204}
-\definecolor{successgreen}{RGB}{0, 153, 76}
-\definecolor{warningred}{RGB}{204, 0, 0}
-```
-
-#### Adjusting Page Layout
-
-Modify geometry settings in the style file:
-
-```latex
-\RequirePackage[margin=1in, top=1.2in, bottom=1.2in]{geometry}
-```
-
-#### Custom Fonts (XeLaTeX only)
-
-Uncomment and modify in the style file:
-
-```latex
-\setmainfont{Your Preferred Font}
-\setsansfont{Your Sans-Serif Font}
-```
-
-#### Header/Footer Customization
-
-Modify in the style file:
-
-```latex
-\fancyhead[L]{\color{primaryblue}\sffamily\small\textbf{Treatment Plan Title}}
-\fancyhead[R]{\color{darkgray}\sffamily\small Patient Info}
-```
-
-### Style Package Download and Installation
-
-#### Option 1: Copy to Project Directory
-
-Copy `assets/medical_treatment_plan.sty` to the same directory as your `.tex` file.
-
-#### Option 2: Install to User TeX Directory
-
-```bash
-# Find your local texmf directory
-kpsewhich -var-value TEXMFHOME
-
-# Copy to appropriate location (usually ~/texmf/tex/latex/)
-mkdir -p ~/texmf/tex/latex/medical_treatment_plan
-cp assets/medical_treatment_plan.sty ~/texmf/tex/latex/medical_treatment_plan/
-
-# Update TeX file database
-texhash ~/texmf
-```
-
-#### Option 3: System-Wide Installation
-
-```bash
-# Copy to system texmf directory (requires sudo)
-sudo cp assets/medical_treatment_plan.sty /usr/local/texlive/texmf-local/tex/latex/
-sudo texhash
-```
-
-### Additional Professional Styles (Optional)
-
-Other medical/clinical document styles available from CTAN:
-
-**Journal Styles:**
-```bash
-# Install via TeX Live Manager
-tlmgr install nejm        # New England Journal of Medicine
-tlmgr install jama        # JAMA style
-tlmgr install bmj         # British Medical Journal
-```
-
-**General Professional Styles:**
-```bash
-tlmgr install apa7        # APA 7th edition (health sciences)
-tlmgr install IEEEtran    # IEEE (medical devices/engineering)
-tlmgr install springer    # Springer journals
-```
-
-**Download from CTAN:**
-- Visit: https://ctan.org/
-- Search for medical document classes
-- Download and install per package instructions
-
-### Troubleshooting
-
-**Issue: Package not found**
-```bash
-# Install missing packages via TeX Live Manager
-sudo tlmgr update --self
-sudo tlmgr install tcolorbox tikz pgf
-```
-
-**Issue: Missing characters (✓, ≥, etc.)**
-- Use XeLaTeX instead of PDFLaTeX
-- Or replace with LaTeX commands: `$\checkmark$`, `$\geq$`
-- Requires `amssymb` package for math symbols
-
-**Issue: Header height warnings**
-- Style file sets `\setlength{\headheight}{22pt}`
-- Adjust if needed for your content
-
-**Issue: Boxes not rendering**
-```bash
-# Ensure complete tcolorbox installation
-sudo tlmgr install tcolorbox tikz pgf
-```
-
-**Issue: Font not found (XeLaTeX)**
-- Comment out custom font lines in .sty file
-- Or install specified fonts on your system
-
-### Best Practices for Styled Documents
-
-1. **Appropriate Box Usage**
-   - Match box type to content purpose (goals→green, warnings→yellow/red)
-   - Don't overuse boxes; reserve for truly important information
-   - Keep box content concise and focused
-
-2. **Visual Hierarchy**
-   - Use section styling for structure
-   - Boxes for emphasis and organization
-   - Tables for comparative data
-   - Lists for sequential or grouped items
-
-3. **Color Consistency**
-   - Stick to defined color scheme
-   - Use `\textcolor{primaryblue}{\textbf{Text}}` for emphasis
-   - Maintain consistent meaning (red=warning, green=goals)
-
-4. **White Space**
-   - Don't overcrowd pages with boxes
-   - Use `\vspace{0.5cm}` between major sections
-   - Allow breathing room around colored elements
-
-5. **Professional Appearance**
-   - Maintain readability as top priority
-   - Ensure sufficient contrast for accessibility
-   - Test print output in grayscale
-   - Keep styling consistent throughout document
-
-6. **Table Formatting**
-   - Use `\tableheadercolor` for all header rows
-   - Apply `\tablerowcolor` to alternating rows in tables >3 rows
-   - Keep column widths balanced
-   - Use `\small\sffamily` for large tables
-
-### Example: Styled Treatment Plan Structure
-
-```latex
-% !TEX program = xelatex
-\documentclass[11pt,letterpaper]{article}
-\usepackage{medical_treatment_plan}
-\usepackage{natbib}
-
-\title{\textbf{Comprehensive Treatment Plan}\\
-\large{Patient-Centered Care Strategy}}
-\author{Multidisciplinary Care Team}
-\date{\today}
-
-\begin{document}
-\maketitle
-
-\section*{Patient Information}
-\begin{patientinfo}
-  % Demographics table
-\end{patientinfo}
-
-\section{Executive Summary}
-\begin{keybox}[Plan Overview]
-  % Key highlights
-\end{keybox}
-
-\section{Treatment Goals}
-\begin{goalbox}[SMART Goals - 3 Months]
-  \begin{medtable}{Primary Treatment Targets}
-    % Goals table with colored headers
-  \end{medtable}
-\end{goalbox}
-
-\section{Medication Plan}
-\begin{infobox}[Titration Schedule]
-  % Medication instructions
-\end{infobox}
-
-\begin{warningbox}[Critical Decision Point]
-  % Important safety information
-\end{warningbox}
-
-\section{Emergency Protocols}
-\begin{emergencybox}
-  % Emergency contacts
-\end{emergencybox}
-
-\bibliographystyle{plainnat}
-\bibliography{references}
-\end{document}
-```
-
-### Benefits of Professional Styling
-
-**Clinical Practice:**
-- Faster information scanning during patient encounters
-- Clear visual hierarchy for critical vs. routine information
-- Professional appearance suitable for patient-facing documents
-- Color-coded sections reduce cognitive load
-
-**Educational Use:**
-- Enhanced readability for teaching materials
-- Visual differentiation of concept types (goals, warnings, procedures)
-- Professional presentation for case discussions
-- Print and digital-ready formats
-
-**Documentation Quality:**
-- Modern, polished appearance
-- Maintains clinical accuracy while improving aesthetics
-- Standardized formatting across treatment plans
-- Easy to customize for institutional branding
-
-**Patient Engagement:**
-- More approachable than dense text documents
-- Color coding helps patients identify key sections
-- Professional appearance builds trust
-- Clear organization facilitates understanding
-
-## Ethical Considerations
-
-### Informed Consent
-All treatment plans should involve patient understanding and voluntary agreement to proposed interventions.
-
-### Cultural Sensitivity
-Treatment plans must respect diverse cultural beliefs, health practices, and communication styles.
-
-### Health Equity
-Consider social determinants of health, access barriers, and health disparities when developing plans.
-
-### Privacy Protection
-Maintain strict HIPAA compliance; de-identify all protected health information in shared documents.
-
-### Autonomy and Beneficence
-Balance medical recommendations with patient autonomy and values while promoting patient welfare.
-
-## License
-
-Part of the Claude Scientific Writer project. See main LICENSE file.
-