A digital care and support plan makes it easier for care and welfare workers in primary care and beyond to work together. Assembling a care team; planning and dividing care tasks with clarity; creating and sharing care planning; focusing on and sharing the patient’s life, care and support goals; communicating efficiently with each other and with the patient: these are essential elements that a digital care and support plan should enable.
Besides improving collaboration, the main objective is to give patients control regarding the care they want and the parties involved in providing it. Individuals with complex care needs (or their representatives) will thus become key users of their own digital care and support plan.
Enabling the rollout of the new digital care and support plans requires not only technical IT development, but also agreements as regards care planning, the care team, care coordination, etc., as well as indicating who is responsible for what. For both technical development and choices as regards content, the Agency for Care and Health works closely with the various primary care professionals and patient representatives.