CP GPCCMP

Note generated through use of Heidi Health. Verbally consented to the use of AI for note-taking. **Conditions** [List the patient's diagnosed conditions] (Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely. Write as bullet points. Provide further information relevant to the condition underneath each listed condition including any updates, changes, new information relevant to the condition.) **SMART Goals** [list specific, measurable, achievable, relevant, and time-bound goals related to the patient's health management, including targets for clinical measures, assessments, lifestyle adjustments, and education] (Write as bullet points.) **Tasks** **Patient:** [list tasks and actions the patient needs to undertake, including medication adherence, physical activity, dietary changes, scheduling and attending assessments, maintaining health diaries, and engaging with the care team] (Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely. Write as bullet points.) **GP:** [list tasks and responsibilities of the General Practitioner, including medication review, ordering referrals, monitoring clinical measures, coordinating with the multidisciplinary team, and conducting regular reviews] (Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely. Write as bullet points.) **Practice Nurse:** [list tasks and responsibilities of the practice nurse, including monitoring weight, BMI, and blood pressure, providing education and coaching, performing screenings, assessing immunisation status, giving vaccines, and supporting adherence strategies] (Always include relevant preventative health tasks.) **Multidisciplinary Team Members** **Medical Specialist** Clinical rationale: [document the clinical rationale for involving the specialist, including reasons related to the patient's condition and management needs] (Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely. Write in paragraphs of full sentences.) Tasks: [list tasks and responsibilities of the specialist, including reviewing and adjusting pharmacological management, providing guidance on control of chronic condition, and communicating treatment plans] (Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely. Write as bullet points.) **Physiotherapist** Clinical rationale: [document the clinical rationale for involving the physiotherapist, including reasons related to the patient's condition and management needs] (Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely. Write in paragraphs of full sentences.) Tasks: [list tasks and responsibilities of the physiotherapist, including conducting mobility assessments, educating on physical activity, managing weakness, and reporting findings] (Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely. Write as bullet points.) **Podiatrist** Clinical rationale: [document the clinical rationale for involving the podiatrist, including reasons related to the patient's condition and management needs] (Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely. Write in paragraphs of full sentences.) Tasks: [list tasks and responsibilities of the podiatrist, including conducting foot assessments, educating on foot care, managing neuropathy or lesions, and reporting findings] (Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely. Write as bullet points.) **Optometrist/Ophthalmologist** Clinical rationale: [document the clinical rationale for involving the optometrist/ophthalmologist, including reasons related to the patient's condition and management needs] (Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely. Write in paragraphs of full sentences.) Tasks: [list tasks and responsibilities of the optometrist/ophthalmologist, including performing eye exams, identifying signs of retinopathy, advising on follow-up schedules, and providing reports] (Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely. Write as bullet points.) **Dietitian** Clinical rationale: [document the clinical rationale for involving the dietitian, including reasons related to the patient's condition and management needs] (Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely. Write in paragraphs of full sentences.) Tasks: [list tasks and responsibilities of the dietitian, including conducting nutritional assessments, creating meal plans, supporting carbohydrate management, providing diet advice, and communicating progress] (Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely. Write as bullet points.) **Structured Review Arrangements** [list the structured review arrangements, including the frequency of comprehensive reviews, testing schedules, and tracking of assessments and multidisciplinary updates] (Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely. Write as bullet points.) (Never come up with your own patient details, assessment, plan, interventions, evaluation, and plan for continuing care - use only the transcript, contextual notes or clinical note as a reference for the information included in your note. If any information related to a placeholder has not been explicitly mentioned in the transcript, contextual notes or clinical note, you must not state the information has not been explicitly mentioned in your output, just leave the relevant placeholder or omit the placeholder completely.) (Use as many lines, paragraphs or bullet points, depending on the format, as needed to capture all the relevant information from the transcript.) SNAP DIET: [document information discussed regarding diet](Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely) EXERCISE: [document information discussed regarding exercise] (Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely) STRESS: [document information discussed regarding stress and mental health](Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely) ALCOHOL: [document information discussed regarding alcohol use](Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely) SMOKING: [document information discussed re smoking](Only include if explicitly mentioned in transcript, context or clinical note, else omit section entirely)