TABLE OF CONTENTS

Introduction

Living documents sit at the top of a patient's Cortex timeline, and can be edited by any clinician.  


There are two Living Document types - Care Plans and Clinical Summaries. These both have the same functionality but are kept distinct as they solve different problems. 


Living Documents can be 

  • Updated - with immediate visibility of changes to the entire care team.
  • Snapshotted as static notes to provide a record of their content at a defined time
  • Completed once no longer relevant or required


Living Document mandatory questions

When designing a living document, care should be taken to minimise the number of mandatory questions due to the inability to "draft" a living document. This is most relevant during the first iteration of a Care Plan or Clinical Summary. 


One way to manage this is to add an option such as ‘not completed yet’ to mandatory questions, which will allow the document to be saved. A clinician can then update the document later with the correct information. 


Multiple authors

By design, Living Documents are able to be edited by any Cortex user.  Therefore, if a department wishes to restrict who edits the form (or sections of the form), this currently needs to be managed through clear instructions in the Editing view of the form design.


If two users open a living document concurrently, then the first user to save changes "wins". If the second user tries to save any changes they will get a message ‘Someone else has modified or altered this document.  Please wait for sync to complete and try again’ 


Business rules


It is highly recommended that living documents have business processes clearly documented, both within the Cortex form and in externally as departmental business rules.  

These rules need to address: 

  • indications for use - ie. which patients should have this living document.
  • Who is responsible for maintaining the document.
  • When the document is to be updated and snapshotted.
  • When the document is to be ended.
  • Who should be contacted, and how, if the living document has been left open by mistake.


Care Plans

Care Plans are for multistep longitudinal processes.  Examples include: 

  • Inpatient Care Plans
  • Long term interventions (e.g. dialysis prescriptions) 


Clinical Summaries

Clinical Summaries provide a summary of the patient with the goal of providing a rapid understanding of the patient’s situation, for the benefit of both the treating team and for clinicians who are not familiar with the patient.  


They may be particularly useful for complex patient such as: 

  • Inpatients who are long-term or complex 
  • Patients who may be in and out of hospital under a service over a period of time


In general, clinical summaries should be focussed around a specific specialty and egularly curated. They are most useful for  complex patients where having an easily accessible summary improves care.


Please note - 

  • Not all patients may benefit from having a Clinical Summary.
  • They are the responsibility of the Senior Medical Officer or a delegated Junior Medical Officer