Patient Goal Setting¶
Source: Call 34 (3-3), Call 35 (3-18)
Existing plan: itheraputix/symlink_docs/plans/26-3-15_patient-journey-goal-setting.md
Priority: Tier 2 — plan exists, Bawa added safety constraints on 3-18
KB Requirement IDs: #112-#115
Status¶
Detailed implementation plan exists (26-3-15). Patient_journey table designed, 6-phase framework consolidated, goal-setting flow specified. Bawa's 3-18 feedback adds important safety and liability constraints that the plan already anticipated but are now explicitly confirmed.
Requirements From Bawa (3-18)¶
Support goals feature (KB #112)¶
Bawa affirmed the concept of patient recovery goals. Positive acceptance.
NEVER grant clearance — redirect to provider (KB #113)¶
Bawa: "Instead of saying you're ready to go hiking, it's like, make sure you bring that up during your next visit."
This is the strongest safety requirement. The system suggests, motivates, tracks progress — but NEVER says "you're cleared to do X." That's always the provider's call.
Ask what they've been doing, defer decisions (KB #114)¶
Bawa: "Tell us what you've been doing recently... make sure you bring that up at your next visit."
The app gathers information and surfaces it for clinical discussion. It does not evaluate or approve.
Liability awareness (KB #115)¶
Bawa: "We have to be cautious... there's like liability to that too... the app told me I could do this and I shouldn't have done that."
Every goal-related interaction must be designed to avoid creating liability. The system is a tracker and motivator, not a clinician.
Requirements From Bawa (3-3)¶
Phase-based goals¶
Weekly or phase-based goals across the 6 recovery phases. Goals should be appropriate to current phase — don't suggest golf on day 3.
Personalized protocol timing¶
Use goal information alongside onboarding data to customize protocol timing. Goals feed into the adaptive engagement model.
Activity restriction integration¶
Goal suggestions must respect active restrictions. The existing plan handles this with structured blocked_by metadata on goal menu items and LLM negotiation for custom goals.
From Lauryn (3-18)¶
Defer to PT for official clearance (extends KB #113)¶
Lauryn: "Discuss this with your physical therapist. They can check your reaction time... who can officially clear them."
When goal progress suggests readiness (e.g., patient wants to drive), the system should say "discuss with your PT" — not "you're ready."
How 3-18 Feedback Maps to Existing Plan¶
| Bawa requirement | Already in plan? | Notes |
|---|---|---|
| Goals feature supported | Yes — Part 2 | Bawa confirmed |
| Never grant clearance | Yes — activity restriction awareness, redirect_reason in negotiation schema | Now explicitly confirmed as top safety priority |
| Ask what they've been doing | Yes — goal progress observations link via references_goal_id | Plan already designed for this |
| Liability avoidance | Yes — LLM negotiation prompt has NON-NEGOTIABLE restrictions | Now confirmed as explicit requirement, not just design choice |
| Defer to PT | Partially — plan mentions provider clearance but Lauryn's specific "PT can check reaction time" adds detail | Add PT-specific deferral language to negotiation prompt |
Implementation¶
Execute per existing plan (26-3-15): - Phase 1: patient_journey table + data foundation - Phase 2: Goal-setting flow (post-onboarding + phase-transition triggers) - Phase 3: Integration with patient knowledge system (deferred)
Addition from 3-18: Update the Goal Negotiation Prompt's ## RULES section to include explicit deferral language:
- "Never say the patient is cleared, ready, or approved for any activity"
- "Always redirect to 'bring this up at your next visit with Dr. Bawa' or 'discuss with your physical therapist'"
- "If a patient asks 'can I do X?', respond with encouragement about progress but defer the decision"