DME Care Plan¶
Source: 2/18 Meeting (2026-02-18), Jeff's TKA DME Complaint Research (ChatGPT)
Priority: Tier 1 — foundation for equipment chat agent
Status: Planned
Job To Be Done¶
Each patient needs a care plan that reflects their actual equipment assignment — not a generic protocol. The care plan drives equipment-specific reminders, education content, and chat agent knowledge.
"The PT that knows about those numbers. You got the DME that knows exactly what equipment is assigned to you. It doesn't go down a serial number, but it does do the exact model number and we could add a serial number after that." — 2/18 Meeting
Pain¶
- Equipment assignment goes through the doctor/insurance/cash "do-si-do" — a complex negotiation between what the doctor orders, what insurance covers, and what the patient can pay
- Generic protocols don't reflect what equipment the patient actually received
- No system currently tracks the connection between patient, specific equipment, and care instructions
- Delivery and setup details live in field staff notes, not in any patient-facing system
"Right now the industry model is: Deliver equipment, explain once, hope compliance happens. But a TKA patient is basically: medicated, inflamed, scared to move, sleep deprived, cognitively overloaded. So every device becomes a decision burden." — Jeff's research
Value¶
Protocol cloned per patient. DME injects actual equipment details. Care plan drives time-based reminders. Patient gets guidance specific to what they actually have.
"Right now recovery is device-centric. What patients actually need is day-centric. They don't wake up thinking 'I should use my CPM.' They wake up thinking 'Is my knee normal today?' So the platform's job is to answer that question every single day." — Jeff's research
Requirements¶
Accept the final DME decision¶
The system does not automate payer logic or insurance coverage decisions. It accepts whatever equipment the DME assigns to the patient and builds the care plan around that decision.
Protocol cloning per patient¶
Base protocol (e.g., TKR recovery) is cloned for each patient. DME staff inject the actual equipment into the clone.
"We can edit that so that whatever it needs to be... if hey Mike's a runner, he's in good shape, he could be running much earlier than the normal protocol, so we're going to change, we're going to edit this line right here that allows that." — 2/18 Meeting
Equipment-specific content¶
Once equipment is assigned, the care plan includes:
- Setup and orientation — brand/model-specific instructions with video where available
- Daily usage schedule — when to use each piece of equipment, for how long
- Machine settings — extension/flexion ROM targets for CPM, intensity levels for EMS
- Troubleshooting — equipment-specific FAQ (feeds the chat agent)
Delivery and setup tracking¶
"So will this like, will it track when we deliver something or when we set them up or any notes that we put, we set them up zero degrees of extension to 30 degrees of flexion, we can put, will we be doing that too on the DME side?" — 2/18 Meeting
Track when equipment was delivered, who set it up, initial machine settings.
Machine settings (extension/flexion)¶
For CPM: track the doctor's prescribed ROM progression. Day 1 might be 0-30 degrees, progressing to 0-90 over weeks.
"If you gave him the serialized asset... and it's got all the definite descriptions in each, then that will." — 2/18 Meeting
Equipment-specific education with video¶
Video at prehab (before surgery) has higher retention than video at delivery (post-op, medicated).
Day-by-Day Care Plan Structure (from Jeff's research)¶
The care plan should be day-centric, not device-centric:
| Phase | Days | Patient Mindset | Care Plan Role |
|---|---|---|---|
| Surgery Day | 0 | Disoriented, passive | "Your knee is safe to move" |
| Shock Phase | 1-2 | "This was worse than I expected" | Hurt vs harm education, ice schedule, walker coaching |
| Drop-off Window | 3-5 | Discouragement + fatigue | "Swelling peak is normal today," short session stacking |
| Turning Point | 6-10 | "Maybe this will work" | ROM progress chart, walking targets |
| Confidence Week | 11-14 | Hope returns | Prevent pseudo-recovery ("Don't coast") |
| Function Phase | 15-21 | "I want my life back" | Gait correction, activity pacing |
| Outcome Lock-In | 22-30 | Future oriented | Strength benchmarking, return-to-activity |
"Day 3-5 is the most dangerous period in recovery. Compliance collapses here. They expected improvement — instead swelling peaks." — Jeff's research
Integration Points¶
- Equipment Chat Agent — care plan is the knowledge source for the chat agent
- Companion/Caregiver — caretaker sees the same care plan
- DME Dashboard — Pete sees which patients have which equipment and care plan compliance