Care Plan Service — Data Model

Status: populated Owner: TBD Last updated: 2026-04-18 Companion: Service Template · 03 platform-services · 02 DDD

ID Prefix Registry (this service)

Prefix	Entity
cp_	CarePlan
cpg_	CarePlanGoal
cpa_	CarePlanActivity
ctm_	CareTeamMember

All IDs are ULIDs (26-char, lexicographically sortable, millisecond precision).

---

TypeScript Interfaces

export interface CarePlan {
  id: CarePlanId;            // ULID with prefix cp_
  tenantId: TenantId;
  patientId: string;         // pat_ ULID from registration-service
  encounterId?: string;      // enc_ ULID from scheduling-service
  title: string;
  description?: string;
  status: CarePlanStatus;
  category?: CodeableConcept;
  version: number;           // optimistic concurrency
  createdBy: string;         // usr_ ULID
  createdAt: Date;
  updatedAt: Date;
  lastReviewedAt?: Date;
  nextReviewDue?: Date;
  goals?: CarePlanGoal[];
  activities?: CarePlanActivity[];
  careTeamMembers?: CareTeamMember[];
}

export interface CarePlanGoal {
  id: GoalId;                // cpg_
  tenantId: TenantId;
  carePlanId: CarePlanId;
  patientId: string;
  description: string;
  targetDetail?: TargetDetail;
  dueAt?: Date;
  status: GoalStatus;
  createdBy: string;
  createdAt: Date;
  updatedAt: Date;
}

export interface CarePlanActivity {
  id: ActivityId;            // cpa_
  tenantId: TenantId;
  carePlanId: CarePlanId;
  description: string;
  assigneeId?: string;       // prac_ ULID from provider-directory-service
  scheduleDetail?: unknown;  // JSON — repeat/timing
  status: ActivityStatus;
  completedAt?: Date;
  completionNote?: string;
  createdBy: string;
  createdAt: Date;
  updatedAt: Date;
}

export interface CareTeamMember {
  id: CareTeamMemberId;      // ctm_
  tenantId: TenantId;
  carePlanId: CarePlanId;
  practitionerId: string;    // prac_ ULID
  role: CodeableConcept;
  effectiveFrom: Date;
  effectiveTo?: Date;
  createdAt: Date;
}

---

Postgres Schema

-- ============================================================
-- care_plans
-- ============================================================
CREATE TABLE care_plans (
  id            TEXT        PRIMARY KEY,   -- cp_ULID
  tenant_id     TEXT        NOT NULL,
  patient_id    TEXT        NOT NULL,
  encounter_id  TEXT,
  title         TEXT        NOT NULL,
  description   TEXT,
  status        TEXT        NOT NULL DEFAULT 'draft',
  category      JSONB,
  version       INTEGER     NOT NULL DEFAULT 1,
  created_by    TEXT        NOT NULL,
  created_at    TIMESTAMPTZ NOT NULL DEFAULT now(),
  updated_at    TIMESTAMPTZ NOT NULL DEFAULT now(),
  last_reviewed_at TIMESTAMPTZ,
  next_review_due  DATE
);

CREATE INDEX ix_care_plans_tenant_patient ON care_plans (tenant_id, patient_id);
CREATE INDEX ix_care_plans_tenant_status  ON care_plans (tenant_id, status);
CREATE INDEX ix_care_plans_patient_status ON care_plans (patient_id, status);

ALTER TABLE care_plans ENABLE ROW LEVEL SECURITY;
CREATE POLICY care_plans_tenant_isolation ON care_plans
  USING (tenant_id = current_setting('app.current_tenant_id'));

-- ============================================================
-- care_plan_goals
-- ============================================================
CREATE TABLE care_plan_goals (
  id            TEXT        PRIMARY KEY,   -- cpg_ULID
  tenant_id     TEXT        NOT NULL,
  care_plan_id  TEXT        NOT NULL REFERENCES care_plans(id),
  patient_id    TEXT        NOT NULL,
  description   TEXT        NOT NULL,
  target_detail JSONB,
  due_at        DATE,
  status        TEXT        NOT NULL DEFAULT 'proposed',
  created_by    TEXT        NOT NULL,
  created_at    TIMESTAMPTZ NOT NULL DEFAULT now(),
  updated_at    TIMESTAMPTZ NOT NULL DEFAULT now()
);

CREATE INDEX ix_care_plan_goals_care_plan_id ON care_plan_goals (care_plan_id);
CREATE INDEX ix_care_plan_goals_tenant_patient ON care_plan_goals (tenant_id, patient_id);

ALTER TABLE care_plan_goals ENABLE ROW LEVEL SECURITY;
CREATE POLICY care_plan_goals_tenant_isolation ON care_plan_goals
  USING (tenant_id = current_setting('app.current_tenant_id'));

-- ============================================================
-- care_plan_activities
-- ============================================================
CREATE TABLE care_plan_activities (
  id              TEXT        PRIMARY KEY,   -- cpa_ULID
  tenant_id       TEXT        NOT NULL,
  care_plan_id    TEXT        NOT NULL REFERENCES care_plans(id),
  description     TEXT        NOT NULL,
  assignee_id     TEXT,
  schedule_detail JSONB,
  status          TEXT        NOT NULL DEFAULT 'not_started',
  completed_at    TIMESTAMPTZ,
  completion_note TEXT,
  created_by      TEXT        NOT NULL,
  created_at      TIMESTAMPTZ NOT NULL DEFAULT now(),
  updated_at      TIMESTAMPTZ NOT NULL DEFAULT now()
);

CREATE INDEX ix_care_plan_activities_care_plan_id ON care_plan_activities (care_plan_id);
CREATE INDEX ix_care_plan_activities_tenant_status ON care_plan_activities (tenant_id, status);

ALTER TABLE care_plan_activities ENABLE ROW LEVEL SECURITY;
CREATE POLICY care_plan_activities_tenant_isolation ON care_plan_activities
  USING (tenant_id = current_setting('app.current_tenant_id'));

-- ============================================================
-- care_team_members
-- ============================================================
CREATE TABLE care_team_members (
  id               TEXT        PRIMARY KEY,   -- ctm_ULID
  tenant_id        TEXT        NOT NULL,
  care_plan_id     TEXT        NOT NULL REFERENCES care_plans(id),
  practitioner_id  TEXT        NOT NULL,
  role             JSONB       NOT NULL,
  effective_from   DATE        NOT NULL,
  effective_to     DATE,
  created_at       TIMESTAMPTZ NOT NULL DEFAULT now()
);

CREATE INDEX ix_care_team_members_care_plan_id ON care_team_members (care_plan_id);
CREATE INDEX ix_care_team_members_practitioner ON care_team_members (tenant_id, practitioner_id);

ALTER TABLE care_team_members ENABLE ROW LEVEL SECURITY;
CREATE POLICY care_team_members_tenant_isolation ON care_team_members
  USING (tenant_id = current_setting('app.current_tenant_id'));

-- ============================================================
-- outbox (transactional outbox pattern)
-- ============================================================
CREATE TABLE outbox (
  id            TEXT        PRIMARY KEY,
  tenant_id     TEXT        NOT NULL,
  event_type    TEXT        NOT NULL,
  payload       JSONB       NOT NULL,
  created_at    TIMESTAMPTZ NOT NULL DEFAULT now(),
  published_at  TIMESTAMPTZ,
  status        TEXT        NOT NULL DEFAULT 'pending'
);

CREATE INDEX ix_outbox_pending ON outbox (status, created_at) WHERE status = 'pending';

---

Migrations

Migration file	Description
20260418000001_create_care_plans.sql	Initial tables: care_plans, care_plan_goals, care_plan_activities, care_team_members, outbox
20260418000002_add_rls_policies.sql	Enable RLS on all tables
20260418000003_add_next_review_due.sql	Add next_review_due column to care_plans