Care Management/ Care Coordination/ Team Collaboration

Team Collaboration Workspace

Shared notes, task assignments, team messaging, and care documents for active cases

Active Cases (8)
Maria Gonzalez
High Risk
CM: Rosa Diaz
Last activity: 2h ago
Carlos Rodriguez
High Risk
CM: Rosa Diaz
Last activity: 4h ago
Robert Williams
Moderate Risk
CM: Maria Santos
Last activity: Yesterday
Sunita Patel
Moderate Risk
CM: Rosa Diaz
Last activity: Yesterday
Helen Foster
Moderate Risk
CM: David Park
Last activity: Mar 30
James Thompson
Low Risk
CM: David Park
Last activity: Mar 29
Janet Kim
High Risk
CM: Maria Santos
Last activity: Mar 28
David Nguyen
Low Risk
CM: Rosa Diaz
Last activity: Mar 28
Maria Gonzalez High Risk
MBR-4412 · CHF, CKD Stage 3, HTN · Primary CM: Rosa Diaz
Shared Notes
Task Assignments
Team Messages
Files & Attachments
RD
Rosa Diaz, RN (CM)Apr 1, 10:30 AM
Received RPM alert — BP 188/112 at 8:14 AM. Called patient immediately. She reports a headache but no chest pain or vision changes. Instructed patient to rest and take Amlodipine (missed yesterday). Scheduled urgent PCP visit for this afternoon at 2:00 PM with Dr. Amelia Chen. Will follow up at 3:00 PM post-visit.
MS
Dr. Maria Santos, MDMar 29, 3:00 PM
Reviewed labs from Mar 28. Cr stable at 1.8. K+ 4.2 — acceptable. BNP elevated at 412 (up from 280 in January). Recommend echocardiogram repeat and consider Entresto titration. Will discuss at next IDT meeting Apr 5.
DP
David Park, SWMar 27, 9:15 AM
Completed social needs assessment. Patient lives alone, limited transportation. Daughter available on weekends. Applied for LIHEAP energy assistance — approval pending. Referred to Meals on Wheels for nutrition support. Home health aide 3×/week confirmed starting Apr 7.
Page Guide — Team Collaboration
Overview
The Team Collaboration Workspace provides a shared environment for interdisciplinary care teams to coordinate on active cases. All communications and notes are HIPAA-compliant and audit-logged.
  • Select a case from the left panel to load its workspace
  • Use tabs to switch between notes, tasks, messages, and files
Shared Notes
Notes are visible to all care team members assigned to the case. They are timestamped and attributed. Clinical notes entered here are synced to the patient's care plan. Notes are not editable after 24 hours for audit integrity.
Task Assignments
Tasks can be assigned to any care team member. Overdue tasks generate alerts to the assignee and their supervisor. Completed tasks require a brief completion note. Task history is retained for quality review.
File Attachments
Supported file types: PDF, DOCX, XLSX, JPG, PNG. Maximum file size: 25 MB. All files are encrypted at rest and in transit. Files are associated with the patient record and accessible from the main patient chart.