The Context of Use Perspective

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There are three different contexts of use. The differentiating characteristics are: the level of complexity and the duration for which the type of [care] plan is used/remains active.

Level 1

This is the simplest of all the types of plan used with limited scope and complexity.

(Note: It is often referred to as "treatment plan")

The Subject/Target

• Patient/subject of care

The Author(s)

• Patient's primary care provider/general practitioner
• Patient's specialist provider in clinic or hospital practice

Scope and Complexity

• Provider centric
• Problem-oriented
• May be part of SOAP documentation
• Within boundary of single disciple and single care setting/organization

Timeframe/Duration of Use

• Encounter-based (i.e. a new/different plan is generated per encounter)
• Or problem-based (i.e. the same plan may get revised on subsequent encounter/visit until problem requiring care is resolved)

Level 2

This type of plan is used in managing patients with more complex conditions during an episode of care (usually of limited duration)

(Note: This type of plan is often referred to as "care plan" or "plan of care")

The subject/target

• The patient/subject of care

The author(s)

• The patient's health care provider(s), or health care team

The Scope and Complexity

• Provider-centric
• Problem-oriented: involving one or more problems
• Across multiple disciplines/departments (e.g. involving treating physicians/surgeons, nurses, allied health providers, social workers)
• Within the boundary of same health care setting/organization
• May be used as care coordination tool within the boundary of same health care organization

Timeframe/Duration

• Problem(s)-based: plan in use and subjected to changes in response to changing patient condition
• Episode of care-based: plan in use until the episode of care (e.g. hospitalization) is completed

Level 3

This is the most complex form of plan used for coordinating the care/management of patient with multiple and complex chronic conditions.

(Note: It is also known as "care plan", "shared care plan", or "comprehensive care plan").

The Subject/Target

• the patient/subject of care
• the family/significant others

The author(s)

• The healthcare team
• The patient/family

The Scope and Complexity

• Patient/consumer-centric
• Problem(s)-oriented: health problems are complex and chronic
• Across multiple-discipline, multiple care settings/organization boundaries
• Used as care coordination tool across care setting boundaries for managing multiple, complex health problems/conditions

Timeframe/Duration

• longitudinal/lifelong (for duration of lifespan of chronic condition)