scientific-writer 2.2.1__py3-none-any.whl → 2.2.3__py3-none-any.whl

scientific_writer/.claude/skills/treatment-plans/README.md

@@ -0,0 +1,483 @@
+# Treatment Plans Skill
+
+## Overview
+
+Comprehensive skill for generating professional medical treatment plans across all clinical specialties. Provides LaTeX/PDF templates with SMART goal frameworks, evidence-based interventions, regulatory compliance, and validation tools for patient-centered care planning.
+
+## What's Included
+
+### 📋 Six Treatment Plan Types
+
+1. **General Medical Treatment Plans** - Primary care, chronic diseases (diabetes, hypertension, heart failure)
+2. **Rehabilitation Treatment Plans** - Physical therapy, occupational therapy, cardiac/pulmonary rehab
+3. **Mental Health Treatment Plans** - Psychiatric care, depression, anxiety, PTSD, substance use
+4. **Chronic Disease Management Plans** - Complex multimorbidity, long-term care coordination
+5. **Perioperative Care Plans** - Preoperative optimization, ERAS protocols, postoperative recovery
+6. **Pain Management Plans** - Acute and chronic pain, multimodal analgesia, opioid-sparing strategies
+
+### 📚 Reference Files (5 comprehensive guides)
+
+- `treatment_plan_standards.md` - Professional standards, documentation requirements, legal considerations
+- `goal_setting_frameworks.md` - SMART goals, patient-centered outcomes, shared decision-making
+- `intervention_guidelines.md` - Evidence-based treatments, pharmacological and non-pharmacological
+- `regulatory_compliance.md` - HIPAA compliance, billing documentation, quality measures
+- `specialty_specific_guidelines.md` - Detailed guidelines for each treatment plan type
+
+### 📄 LaTeX Templates (6 professional templates)
+
+- `general_medical_treatment_plan.tex` - Comprehensive medical care planning
+- `rehabilitation_treatment_plan.tex` - Functional restoration and therapy
+- `mental_health_treatment_plan.tex` - Psychiatric and behavioral health
+- `chronic_disease_management_plan.tex` - Long-term disease management
+- `perioperative_care_plan.tex` - Surgical and procedural care
+- `pain_management_plan.tex` - Multimodal pain treatment
+
+### 🔧 Validation Scripts (4 automation tools)
+
+- `generate_template.py` - Interactive template selection and generation
+- `validate_treatment_plan.py` - Comprehensive quality and compliance checking
+- `check_completeness.py` - Verify all required sections present
+- `timeline_generator.py` - Create visual treatment timelines and schedules
+
+## Quick Start
+
+### Generate a Treatment Plan Template
+
+```bash
+cd .claude/skills/treatment-plans/scripts
+python generate_template.py
+
+# Or specify type directly
+python generate_template.py --type general_medical --output diabetes_plan.tex
+```
+
+Available template types:
+- `general_medical`
+- `rehabilitation`
+- `mental_health`
+- `chronic_disease`
+- `perioperative`
+- `pain_management`
+
+### Compile to PDF
+
+```bash
+cd /path/to/your/treatment/plan
+pdflatex my_treatment_plan.tex
+```
+
+### Validate Your Treatment Plan
+
+```bash
+# Check for completeness
+python check_completeness.py my_treatment_plan.tex
+
+# Comprehensive validation
+python validate_treatment_plan.py my_treatment_plan.tex
+```
+
+### Generate Treatment Timeline
+
+```bash
+python timeline_generator.py --plan my_treatment_plan.tex --output timeline.pdf
+```
+
+## Standard Treatment Plan Components
+
+All templates include these essential sections:
+
+### 1. Patient Information (De-identified)
+- Demographics and relevant medical background
+- Active conditions and comorbidities
+- Current medications and allergies
+- Functional status baseline
+- HIPAA-compliant de-identification
+
+### 2. Diagnosis and Assessment Summary
+- Primary diagnosis (ICD-10 coded)
+- Secondary diagnoses
+- Severity classification
+- Functional limitations
+- Risk stratification
+
+### 3. Treatment Goals (SMART Format)
+
+**Short-term goals** (1-3 months):
+- Specific, measurable outcomes
+- Realistic targets with defined timeframes
+- Patient-centered priorities
+
+**Long-term goals** (6-12 months):
+- Disease control targets
+- Functional improvement objectives
+- Quality of life enhancement
+- Complication prevention
+
+### 4. Interventions
+
+- **Pharmacological**: Medications with dosages, frequencies, monitoring
+- **Non-pharmacological**: Lifestyle modifications, behavioral interventions, education
+- **Procedural**: Planned procedures, specialist referrals, diagnostic testing
+
+### 5. Timeline and Schedule
+- Treatment phases with timeframes
+- Appointment frequency
+- Milestone assessments
+- Expected treatment duration
+
+### 6. Monitoring Parameters
+- Clinical outcomes to track
+- Assessment tools and scales
+- Monitoring frequency
+- Intervention thresholds
+
+### 7. Expected Outcomes
+- Primary outcome measures
+- Success criteria
+- Timeline for improvement
+- Long-term prognosis
+
+### 8. Follow-up Plan
+- Scheduled appointments
+- Communication protocols
+- Emergency procedures
+- Transition planning
+
+### 9. Patient Education
+- Condition understanding
+- Self-management skills
+- Warning signs
+- Resources and support
+
+### 10. Risk Mitigation
+- Adverse effect management
+- Safety monitoring
+- Emergency action plans
+- Fall/infection prevention
+
+## Common Use Cases
+
+### 1. Type 2 Diabetes Management
+
+```
+Goal: Create comprehensive treatment plan for newly diagnosed diabetes
+
+Template: general_medical_treatment_plan.tex
+
+Key Components:
+- SMART goals: HbA1c <7% in 3 months, weight loss 10 lbs in 6 months
+- Medications: Metformin titration schedule
+- Lifestyle: Diet, exercise, glucose monitoring
+- Monitoring: HbA1c every 3 months, quarterly visits
+- Education: Diabetes self-management education
+```
+
+### 2. Post-Stroke Rehabilitation
+
+```
+Goal: Develop rehab plan for stroke patient with hemiparesis
+
+Template: rehabilitation_treatment_plan.tex
+
+Key Components:
+- Functional assessment: FIM scores, ROM, strength testing
+- PT goals: Ambulation 150 feet with cane in 12 weeks
+- OT goals: Independent ADLs, upper extremity function
+- Treatment schedule: PT/OT/SLP 3x week each
+- Home exercise program
+```
+
+### 3. Major Depressive Disorder
+
+```
+Goal: Create integrated treatment plan for depression
+
+Template: mental_health_treatment_plan.tex
+
+Key Components:
+- Assessment: PHQ-9 score 16 (moderate depression)
+- Goals: Reduce PHQ-9 to <5, return to work in 12 weeks
+- Psychotherapy: CBT weekly sessions
+- Medication: SSRI with titration schedule
+- Safety planning: Crisis contacts, warning signs
+```
+
+### 4. Total Knee Replacement
+
+```
+Goal: Perioperative care plan for elective TKA
+
+Template: perioperative_care_plan.tex
+
+Key Components:
+- Preop optimization: Medical clearance, medication management
+- ERAS protocol implementation
+- Postop milestones: Ambulation POD 1, discharge POD 2-3
+- Pain management: Multimodal analgesia
+- Rehab plan: PT starting POD 0
+```
+
+### 5. Chronic Low Back Pain
+
+```
+Goal: Multimodal pain management plan
+
+Template: pain_management_plan.tex
+
+Key Components:
+- Pain assessment: Location, intensity, functional impact
+- Goals: Reduce pain 7/10 to 3/10, return to work
+- Medications: Non-opioid analgesics, adjuvants
+- PT: Core strengthening, McKenzie exercises
+- Behavioral: CBT for pain, mindfulness
+- Interventional: Consider ESI if inadequate response
+```
+
+## SMART Goals Framework
+
+All treatment plans use SMART criteria for goal-setting:
+
+- **Specific**: Clear, well-defined outcome (not vague)
+- **Measurable**: Quantifiable metrics or observable behaviors
+- **Achievable**: Realistic given patient capabilities and resources
+- **Relevant**: Aligned with patient priorities and values
+- **Time-bound**: Specific timeframe for achievement
+
+### Examples
+
+**Good SMART Goals**:
+- Reduce HbA1c from 8.5% to <7% within 3 months
+- Walk independently 150 feet with assistive device by 8 weeks
+- Decrease PHQ-9 depression score from 18 to <10 in 8 weeks
+- Achieve knee flexion >90 degrees by postoperative day 14
+- Reduce pain from 7/10 to ≤4/10 within 6 weeks
+
+**Poor Goals** (not SMART):
+- "Feel better" (not specific or measurable)
+- "Improve diabetes" (not specific or time-bound)
+- "Get stronger" (not measurable)
+- "Return to normal" (vague, not specific)
+
+## Workflow Examples
+
+### Standard Treatment Plan Workflow
+
+1. **Assess patient** - Complete history, physical, diagnostic testing
+2. **Select template** - Choose appropriate template for clinical context
+3. **Generate template** - `python generate_template.py --type [type]`
+4. **Customize plan** - Fill in patient-specific information (de-identified)
+5. **Set SMART goals** - Define measurable short and long-term goals
+6. **Specify interventions** - Evidence-based pharmacological and non-pharmacological
+7. **Create timeline** - Schedule appointments, milestones, reassessments
+8. **Define monitoring** - Outcome measures, assessment frequency
+9. **Validate completeness** - `python check_completeness.py plan.tex`
+10. **Quality check** - `python validate_treatment_plan.py plan.tex`
+11. **Review quality checklist** - Compare to `quality_checklist.md`
+12. **Generate PDF** - `pdflatex plan.tex`
+13. **Review with patient** - Shared decision-making, confirm understanding
+14. **Implement and document** - Execute plan, track progress in clinical notes
+15. **Reassess and modify** - Adjust plan based on outcomes
+
+### Multidisciplinary Care Plan Workflow
+
+1. **Identify team members** - PCP, specialists, therapists, case manager
+2. **Create base plan** - Generate template for primary condition
+3. **Add specialty sections** - Integrate consultant recommendations
+4. **Coordinate goals** - Ensure alignment across disciplines
+5. **Define communication** - Team meeting schedule, documentation sharing
+6. **Assign responsibilities** - Clarify who manages each intervention
+7. **Create care timeline** - Coordinate appointments across providers
+8. **Share plan** - Distribute to all team members and patient
+9. **Track collectively** - Shared monitoring and outcome tracking
+10. **Regular team review** - Adjust plan collaboratively
+
+## Best Practices
+
+### Patient-Centered Care
+✓ Involve patients in goal-setting and decision-making  
+✓ Respect cultural beliefs and language preferences  
+✓ Address health literacy with appropriate language  
+✓ Align plan with patient values and life circumstances  
+✓ Support patient activation and self-management  
+
+### Evidence-Based Practice
+✓ Follow current clinical practice guidelines  
+✓ Use interventions with proven efficacy  
+✓ Incorporate quality measures (HEDIS, CMS)  
+✓ Avoid low-value or ineffective interventions  
+✓ Update plans based on emerging evidence  
+
+### Regulatory Compliance
+✓ De-identify per HIPAA Safe Harbor method (18 identifiers)  
+✓ Document medical necessity for billing support  
+✓ Include informed consent documentation  
+✓ Sign and date all treatment plans  
+✓ Maintain professional documentation standards  
+
+### Quality Documentation
+✓ Complete all required sections  
+✓ Use clear, professional medical language  
+✓ Include specific, measurable goals  
+✓ Specify exact medications (dose, route, frequency)  
+✓ Define monitoring parameters and frequency  
+✓ Address safety and risk mitigation  
+
+### Care Coordination
+✓ Communicate plan to entire care team  
+✓ Define roles and responsibilities  
+✓ Coordinate across care settings  
+✓ Integrate specialist recommendations  
+✓ Plan for care transitions  
+
+## Integration with Other Skills
+
+### Clinical Reports
+- **SOAP Notes**: Document treatment plan implementation and progress
+- **H&P Documents**: Initial assessment informs treatment planning
+- **Discharge Summaries**: Summarize treatment plan execution
+- **Progress Notes**: Track goal achievement and plan modifications
+
+### Scientific Writing
+- **Citation Management**: Reference clinical practice guidelines
+- **Literature Review**: Understand evidence base for interventions
+- **Research Lookup**: Find current treatment recommendations
+
+### Research
+- **Research Grants**: Treatment protocols for clinical trials
+- **Clinical Trial Reports**: Document trial interventions
+
+## Clinical Practice Guidelines
+
+Treatment plans should align with evidence-based guidelines:
+
+### 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 Physical Therapy Clinical Practice Guidelines
+- AOTA Occupational Therapy Practice Guidelines
+- AHA/AACVPR Cardiac Rehabilitation Guidelines
+- Stroke Rehabilitation Best Practices
+
+### Mental Health
+- APA (American Psychiatric Association) Practice Guidelines
+- VA/DoD Clinical Practice Guidelines for Mental Health
+- NICE Guidelines (UK)
+- Evidence-based psychotherapy protocols (CBT, DBT, ACT)
+
+### Pain Management
+- CDC Opioid Prescribing Guidelines
+- AAPM (American Academy of Pain Medicine) Guidelines
+- WHO Analgesic Ladder
+- Multimodal Analgesia Best Practices
+
+### Perioperative Care
+- ERAS (Enhanced Recovery After Surgery) Society Guidelines
+- ASA Perioperative Guidelines
+- SCIP (Surgical Care Improvement Project) Measures
+
+## Professional Standards
+
+### Documentation Requirements
+- Complete and accurate patient information
+- Clear diagnosis with appropriate ICD-10 coding
+- Evidence-based interventions
+- Measurable goals and outcomes
+- Defined monitoring and follow-up
+- Provider signature, credentials, and date
+
+### Medical Necessity
+Treatment plans must demonstrate:
+- Medical appropriateness of interventions
+- Alignment with diagnosis and severity
+- Evidence supporting treatment choices
+- Expected outcomes and benefit
+- Frequency and duration justification
+
+### Legal Considerations
+- Informed consent documentation
+- Patient understanding and agreement
+- Risk disclosure and mitigation
+- Professional liability protection
+- Compliance with state/federal regulations
+
+## Support and Resources
+
+### Getting Help
+
+1. **Check reference files** - Comprehensive guidance in `references/` directory
+2. **Review templates** - See example structures in `assets/` directory
+3. **Run validation scripts** - Identify issues with automated tools
+4. **Consult SKILL.md** - Detailed documentation and best practices
+5. **Review quality checklist** - Ensure all quality criteria met
+
+### External Resources
+
+- Clinical practice guidelines from specialty societies
+- UpToDate and DynaMed for treatment recommendations
+- AHRQ Effective Health Care Program
+- Cochrane Library for intervention evidence
+- CMS Quality Measures and HEDIS specifications
+- HEDIS (Healthcare Effectiveness Data and Information Set)
+
+### Professional Organizations
+
+- American Medical Association (AMA)
+- American Academy of Family Physicians (AAFP)
+- Specialty society guidelines (ADA, ACC, AHA, APA, etc.)
+- Joint Commission standards
+- Centers for Medicare & Medicaid Services (CMS)
+
+## Frequently Asked Questions
+
+### How do I choose the right template?
+
+Match the template to your primary clinical focus:
+- **Chronic medical conditions** → general_medical or chronic_disease
+- **Post-surgery or injury** → rehabilitation or perioperative
+- **Psychiatric conditions** → mental_health
+- **Pain as primary issue** → pain_management
+
+### What if my patient has multiple conditions?
+
+Use the `chronic_disease_management_plan.tex` template for complex multimorbidity, or choose the template for the primary condition and add sections for comorbidities.
+
+### How often should treatment plans be updated?
+
+- **Initial creation**: At diagnosis or treatment initiation
+- **Regular updates**: Every 3-6 months for chronic conditions
+- **Significant changes**: When goals are met or treatment is modified
+- **Annual review**: Minimum for all chronic disease plans
+
+### Can I modify the LaTeX templates?
+
+Yes! Templates are designed to be customized. Modify sections, add specialty-specific content, or adjust formatting to meet your needs.
+
+### How do I ensure HIPAA compliance?
+
+- Remove all 18 HIPAA identifiers (see Safe Harbor method)
+- Use age ranges instead of exact ages (e.g., "60-65" not "63")
+- Remove specific dates, use relative timelines
+- Omit geographic identifiers smaller than state
+- Use `check_deidentification.py` script from clinical-reports skill
+
+### What if validation scripts find issues?
+
+Review the specific issues identified, consult reference files for guidance, and revise the plan accordingly. Common issues include:
+- Missing required sections
+- Goals not meeting SMART criteria
+- Insufficient monitoring parameters
+- Incomplete medication information
+
+## License
+
+Part of the Claude Scientific Writer project. See main LICENSE file.
+
+---
+
+For detailed documentation, see `SKILL.md`. For issues or questions, consult the comprehensive reference files in the `references/` directory.
+