# Meduvo Health — CoCM Platform: Complete Master Analysis & Build Guide

*A single merged document combining: the Product Development Specification (10 pages), the Screen Mockups (25 screens, S1–S23), the Workflow Infographics (Meduvo + DOVO versions), and the "Screen by Screen" poster maps.*

---

## PART 1 — WHAT IS ACTUALLY BEING BUILT (Plain English)

**CoCM = Collaborative Care Model.** It is a real, CMS-recognized (Medicare) clinical program where a **regular doctor's office (Primary Care)** starts treating depression/anxiety *inside* primary care, instead of just referring the patient out to a separate mental-health clinic (where most patients never actually go).

Three extra people get added around the doctor:
1. **Behavioral Health Manager (BHM)** — a care manager (often a social worker) who calls/texts the patient regularly, tracks their mood scores, and manages their case like a project manager manages a project.
2. **Psychiatric Consultant** — a psychiatrist who never actually meets the patient face-to-face (usually) but reviews a whole list of cases once a week and gives medication/therapy advice to the BHM and PCP.
3. **The Patient** — fills out short questionnaires (PHQ-9 for depression, GAD-7 for anxiety) repeatedly over months so everyone can see if they are improving.

**Meduvo Health is the software (EMR add-on module)** that makes this entire relay-race possible: it moves the patient's screening scores, consent, referral, notes, and billable minutes between all four people automatically, tracks time for billing (because Medicare pays doctors *by the minute* for this — CPT codes 99492/99493/99494/G2214), and keeps a legal audit trail.

### Real-life analogy
Think of it like a **hospital triage relay** crossed with a **CRM (like Salesforce) for mental health**:
- The receptionist (tablet) hands the patient a form (like a restaurant table's QR-code menu).
- The kitchen (scoring engine) instantly calculates the "order" (severity score).
- The waiter (PCP) sees it immediately and decides whether to escalate to the "chef" (BHM).
- The BHM is like a **case manager at a call center** — has a queue, calls people, logs outcomes, sets follow-ups.
- The psychiatrist is like a **remote specialist doing chart reviews once a week**, like a radiologist reading a batch of X-rays without ever meeting the patient.
- The billing engine is like an **Uber fare meter** — it only lets you "cash out" (submit a claim) once all the required minutes, consent, and documentation are actually there — it won't let you bill for a ride that never happened.

---

## PART 2 — THE FIVE ROLES (Actors) and What Each One Does

| Role | Who they are in real life | What they do in the app | Device |
|---|---|---|---|
| **Prospect/Provider (unauthenticated)** | A clinic owner/office manager researching the product | Views marketing site, clicks "CoCM for Providers" | Desktop browser |
| **PCP / Practice Staff (Provider)** | Family doctor, nurse, front-desk staff | Registers practice, signs in, checks patients in, assigns screenings, reviews scores, gets consent, sends referral, sees dashboard/reports | Desktop, in-room |
| **Patient** | The person being screened | Confirms identity on tablet, answers PHQ-9/GAD-7 questions, submits, signs consent, optionally joins a live 3-way call | In-office Tablet (kiosk mode) |
| **BHM — Behavioral Health Manager (Care Manager)** | Social worker / mental health case manager employed by (or contracted to) the practice | Works a referral queue, reviews chart, calls the patient, builds a care plan, logs time, tracks repeat assessments, escalates high-risk cases | Desktop (+ phone) |
| **Psychiatric Consultant** | A psychiatrist who consults *without* seeing the patient directly (this is the "C" that makes CoCM billable at the higher rate) | Weekly/bi-weekly review of the whole risk caseload, writes recommendations, sends them back to BHM & PCP | Desktop (Psychiatrist Portal) — **this is Phase 2, NOT in the 10–15 day MVP** |
| **Billing/Care Team (implicit 6th "role")** | Practice biller or office manager | Views time ledger, resolves missing documentation, releases the monthly claim | Desktop |

---

## PART 3 — HOW DATA FLOWS THROUGH THE WHOLE SYSTEM (Architecture in Plain English)

```
Website  →  Provider Login  →  Provider Dashboard
     │
     ▼
Patient Search/Register  →  Assign Assessment (PHQ-9/GAD-7 etc.)
     │
     ▼
Tablet handed to patient (kiosk/lockdown mode)
     │
     ▼
Patient: Identity Confirm → Instructions → Answers Questions (auto-save each answer)
     │                                              │
     │                                    [SAFETY CHECK ON EVERY ANSWER]
     │                                    If any self-harm/suicide item is
     │                                    positive → HARD STOP → alert staff
     │                                    immediately, before patient can
     │                                    finish routine submission
     ▼
Review & Submit → Thank You / Auto-Lock (tablet returns to idle)
     │
     ▼
PCP desktop gets a REAL-TIME notification (no page refresh needed)
     │
     ▼
PCP: Scoring & Risk Detail (sees severity, trend vs last visit, system-suggested next step)
     │
     ▼
PCP + Patient together: "In-Room Discussion" (patient-friendly simplified chart)
     │
     ├── Patient declines → reason logged → soft follow-up task created → END (for now)
     │
     └── Patient accepts →
             ▼
        eConsent Capture (signature, timestamp, consent version — legally binding)
             ▼
        PCP creates Referral (auto-attaches full clinical bundle) → assigns BHM (auto or manual)
             ▼
        System checks: "Is the assigned BHM online RIGHT NOW?"
             │
             ├── YES → Live 3-Way Call (PCP + Patient + BHM, before patient leaves the building)
             │              → BHM does the full intake **live**, writes care plan in real time
             │
             └── NO → Schedule a follow-up visit instead (calendar picker of BHM's open slots)
             ▼
        Referral lands in BHM's Queue regardless of which path was taken
             ▼
        BHM: Open Chart → Outreach & Engagement Log (call/text/portal, log outcome)
             ▼
        BHM: Care Plan Creation (goals + interventions, from a template library)
             ▼
        BHM: Ongoing Case Management (LOOP — this repeats every 2–4 weeks for months)
             │      - progress notes
             │      - repeat PHQ-9/GAD-7 at intervals
             │      - time tracking (minutes → mapped to CPT codes)
             │      - "Escalate to Psychiatrist" button if patient isn't improving or risk rises
             ▼
        [Phase 2] Psychiatrist: Weekly Caseload Review → sends recommendation
             ▼
        Recommendation lands back with BHM (implements it) and PCP (dashboard alert)
             ▼
        Monthly: Billing/Care Team reviews Time Ledger + Documentation Completeness
             → "Release Claim" only if: consent + care plan + required minutes +
               psychiatric availability + complete documentation are ALL present
             ▼
        Claims/Reports exported (claim-ready, under the billing practitioner's NPI)
```

This is a **closed loop, not a one-way pipe** — the bottom rows (S22 → S23 → back to S22, and back up to S3 for PCP alerts) show that a single patient stays "in the loop" for months, with the system pinging every actor when it's their turn — very similar to how a support ticketing system (like Zendesk) keeps re-assigning a ticket between tiers until it's resolved.

---

## PART 4 — SCREEN-BY-SCREEN WALKTHROUGH (All 25 Screens, Merged from Both Mockup Decks)

Below, every screen includes: **Purpose · Actor · Device · Trigger · What happens next · Every field/element on it · A real-life comparison.**

### SECTION A — PCP Desktop: Sign-in through Hand-off

**S1 — Website Home ("CoCM for Providers")**
- Purpose: Marketing landing page; entry point for a clinic that wants to sign up.
- Actor: Prospect/unauthenticated visitor. Device: Desktop browser.
- Fields/Elements: Nav (Home, Solutions, About, "CoCM for Providers", Contact), Hero banner (headline + image), primary CTA button, footer (company/legal links).
- Data captured: none — just page-view analytics.
- Real-life comparison: Like a bank's public website before you log into online banking.

**S2 — Provider Sign-In**
- Purpose: Authenticate practice staff.
- Actor: PCP/practice staff. Device: Desktop browser.
- Fields: Practice/Organization selector (dropdown, only if staff belongs to >1 practice), Email/Username (required), Password (required, masked), "Remember this device" checkbox, MFA one-time code (conditional — only if MFA enabled), links: Forgot Password, Register Practice.
- Data captured: hashed credentials (never stored in plaintext), device fingerprint if "remember" checked.
- Real-life comparison: Exactly like logging into Gmail with 2FA.

**S3 — CoCM Dashboard (PCP Home)**
- Purpose: The doctor's/office's daily control tower.
- Actor: PCP. Device: Desktop (responsive).
- Fields/Elements: Top nav (Dashboard, Patient Registry, Referrals, Reports, Settings), "Patient Registry" widget (active CoCM patient count, new this week), "Tasks & Alerts" widget (overdue follow-ups, safety alerts, pending consents), primary CTA "Assign Assessment"/"New Patient Screening", "Recent Activity" feed.
- Real-life comparison: Like the dashboard view in a CRM (e.g., HubSpot) showing "open deals," "tasks due," "recent activity."

**S4 — Patient Search / Register Patient**
- Purpose: Find an existing patient or add a brand-new one.
- Actor: PCP or front-desk. Device: Desktop, at check-in.
- Fields: Search box (name/DOB/MRN), search results table, "Register New Patient" button (shown only if no match), New Patient form (Name, DOB, Sex, Contact Info, Insurance, PCP of record), "Continue to Assessment" button.
- Real-life comparison: Like searching a hotel reservation system — if the guest exists, pull the record; if not, create a new profile.

**S5 — Assign Assessment**
- Purpose: The doctor picks which screening tools the patient should take today.
- Actor: PCP. Device: Desktop, in-room.
- Fields: Instrument checklist (PHQ-9, GAD-7, PROMIS, AUDIT-C, custom tools — checkboxes), Visit reason/notes (free text, optional context for BHM), Tablet selector (dropdown — which physical kiosk to push to), "Send to Tablet" button.
- Data captured: Patient ID, chosen instrument IDs, session token, timestamp, assigning provider ID.
- Real-life comparison: Like a doctor ticking boxes on a lab-order form ("CBC, Lipid Panel") except it's psychological questionnaires instead of blood tests.

**S6 — Hand Tablet to Patient**
- Purpose: Confirms the assessment successfully reached the tablet; staff physically hands over the device.
- Actor: PCP/staff. Device: Desktop status view + physical tablet.
- Fields: Status banner ("Assessment sent to Tablet #12 — waiting for patient to begin"), Live status indicator (Not started/In progress/Complete), "Cancel/Reassign" button.
- Real-life comparison: Like a restaurant "order sent to kitchen" ticket status.

### SECTION B — Patient Tablet: Real-Time Assessment (Kiosk Mode)

**S7 — Tablet: Identity Confirm (Kiosk Mode)**
- Purpose: Make sure the right patient is answering (privacy/safety).
- Actor: Patient. Device: In-office tablet, locked kiosk mode (cannot exit to home screen — this is a security requirement, same as an airport self-check-in kiosk).
- Fields: Welcome message, Patient first name + partial DOB (read-only, pulled from session), "Yes, this is me" button, "This isn't me / Get staff" escalation button.
- Real-life comparison: Airport self-check-in kiosk asking "Is this you?" before printing a boarding pass.

**S8 — Assessment Instructions**
- Purpose: Explain purpose/privacy/time before starting.
- Fields: Instructions text (purpose, confidentiality, estimated time), Privacy notice, "Begin" button, Language selector dropdown (if multi-language supported).

**S9 — Assessment Questions (dynamic, per instrument)**
- Purpose: Actual question-by-question screening.
- Fields: Progress bar ("Question 4 of 9 — PHQ-9"), Question text, Response options (instrument-defined scale, e.g., 0–3 for PHQ-9), Back/Next buttons, Auto-advance to next instrument after last question of current one.
- Data captured: Per-question response value, instrument ID, question ID, response timestamp (every single answer is saved instantly — nothing is lost if the tablet loses power).
- **Critical safety rule (from the Product Spec, Section 5):** Any positive self-harm response creates an immediate clinician alert and **prevents routine completion until acknowledged** — this is a hard stop, not a soft warning.

**S10 — Review & Submit**
- Fields: Summary confirmation ("You've completed all questions. Submit your responses?"), "Submit" button, "Go back and review" button.

**S11 — Tablet: Thank You / Auto-Lock**
- Fields: Thank-you message, Auto-lock timer (system, returns to kiosk idle screen).
- Real-life comparison: Same UX pattern as a credit-card payment terminal returning to its idle screen after a transaction.

### SECTION C — Results, Consent, Referral & Real-Time BHM Decision

**S12 — PCP: Results Notification (real time)**
- Fields: Toast/banner ("[Patient Name]'s assessment is ready"), Notification badge, "View Results" button.
- Real-life comparison: Like a hospital lab system pinging the ordering doctor the moment blood results are back.

**S13 — PCP: Scoring & Risk Detail**
- Fields: Score summary cards (Total score + severity band per instrument, e.g., "PHQ-9: 14, Moderate"), Risk flag banner (highlighted if suicidal ideation flag present), Trend chart (current vs. prior sessions), Recommendations panel (system-suggested next steps by score threshold — decision support, NOT a diagnosis), "Discuss with Patient" button.

**S14 — PCP: In-Room Discussion View**
- Fields: Simplified score visualization (patient-friendly), CoCM program explainer, "Offer CoCM" button, "Not now/Decline" button.
- Data captured: Decline reason if selected (not interested/insurance concern/will consider later).

**S15 — eConsent Capture**
- Fields: Consent document text (program description, billing/data-sharing disclosure), Signature capture pad, Date/time stamp, "I agree and consent to participate" button.
- Data captured: Signature image/attestation, consent version, timestamp, signing patient ID, witnessing provider ID. This record is **legally immutable** (per Section 2 acceptance criteria: "E-signature evidence is immutable and exportable").

**S16 — PCP: Create Referral**
- Fields: Referral summary preview (demographics, visit reason, notes, scores, risk flags, meds/allergies, insurance/PCP info), BHM assignment dropdown ("Auto-assign" caseload-balancing OR manual pick), "Send Referral" button (one-click).

**S17 — System: Check BHM Real-Time Availability**
- Fields: Availability status ("Available now / In session / Offline"), "Start Live Collaborative Call" button (enabled only if BHM is Available), "Schedule Follow-Up Instead" button (always available).
- This is the single cleverest workflow decision in the whole product — it tries to close the loop **before the patient leaves the building**, because no-show rates for off-site referrals in real clinics are notoriously high (this is *the* reason CoCM programs fail without this feature).

**S17A — Live 3-Way Collaborative Call**
- Fields: Embedded WebRTC video/audio window, Shared assessment summary panel, Live care-plan notes field (BHM types in real time), "End Call & Complete Intake" button.
- Real-life comparison: Like a 3-way conference call your bank sometimes does — you, the branch teller, and a specialist on speakerphone — resolving something on the spot instead of "we'll get back to you."

**S17B — Schedule Follow-Up Visit** (fallback if BHM is offline)
- Fields: Interactive calendar/time-slot picker (BHM's open slots), Contact method preference dropdown (Phone/Video/Portal), "Confirm Appointment" button, Confirmation summary.

### SECTION D — BHM Case Management

**S18 — BHM: Referral Queue**
- Fields: Referral queue list (sorted by priority/risk), Alert bell (new referral notification), Referral row (patient name, referring PCP, risk-flag indicator, date received).
- Real-life comparison: Exactly like a customer-support agent's ticket inbox (Zendesk/Freshdesk), sorted by SLA/priority.

**S19 — BHM: Patient Chart Review**
- Fields: Patient chart panel (demographics, visit reason, clinical notes, scores, risk flags, meds/allergies, insurance/PCP info), Prior CoCM history (if returning patient), "Begin Outreach" button.

**S20 — BHM: Outreach & Engagement Log**
- Fields: Contact method selector (Phone call/Portal message/Text), Outcome log (Reached/Left message/No answer + notes), "Schedule Initial Visit" button.

**S21 — BHM: Care Plan Creation**
- Fields: Care plan template selector (practice's intervention library), Goals field (patient-specific treatment goals), Intervention plan (planned brief interventions/referrals), "Save Care Plan" button.

**S22 — BHM: Ongoing Case Management (the recurring loop)**
- Fields: Progress notes log, Repeat assessment scheduler (triggers PHQ-9/GAD-7 re-administration at set intervals), Time tracking widget (minutes → mapped to CPT 99492/99493/99494), "Escalate to Psychiatric Consultant" button.
- This screen is visited **again and again** for the same patient, month after month — it's the "maintenance loop" of the whole system.

**S23 — Psychiatrist: Weekly Case Review** *(Phase 2 — explicitly marked "not in MVP build scope")*
- Fields: Caseload review list (all active high-risk/escalated patients), Case detail panel (scores, trends, care plan, progress notes), Treatment recommendation form (medication/therapy suggestions), "Send Recommendations to BHM & PCP" button.
- Loops back to S22, and the PCP gets notified via the S3 dashboard alert widget.

---

## PART 5 — THE SEVEN CORE MODULES TO ACTUALLY BUILD (from the Product Development Plan)

1. **Assessments Engine** — library of tools (PHQ-9, GAD-7, AUDIT-C, PROMIS...), real-time scoring, custom forms.
2. **CoCM Dashboard (PCP)** — patient registry, scores & trends, alerts & tasks.
3. **Referral & eConsent** — one-click referral, eConsent capture, status tracking.
4. **BHM Dashboard** — referral queue, patient list, care plans & notes.
5. **Psychiatrist Portal** — case review queue, recommendations, communication (Phase 2).
6. **Collaborative Hub** — secure messaging, tasks/notifications, team collaboration.
7. **Reporting & Analytics** — outcomes reports, billing & time tracking, quality metrics.

**Underlying shared infrastructure (not a "screen" but must exist under everything):** a common **Patient Registry** and an **Audit Trail** — every module reads/writes to these two things. This is like the "database of record" in any SaaS product: all seven modules are really just different *views* onto the same patient object.

---

## PART 6 — DATA MODEL (Key Entities & How They Relate)

```
Patient ──< Assessment (Questionnaire, Response, Score) 
   │
   ├──< CoCM Consent
   │
   ├──< Referral ──< Case Review ──< Recommendation
   │        │
   │        └──< Care Plan ──< Progress Note
   │
   ├──< Communication/Message
   │
   └──< Time Tracking / Billing (CPT Code) ──> Outcome Report
```
- **Patient** is the hub; everything else hangs off the Patient ID.
- **Referral** is the "case file" that gets created once and is shared by PCP, BHM, and Psychiatrist.
- **Care Plan** and **Progress Notes** belong to the BHM's ongoing loop.
- **Time Tracking** rolls up into **Billing/CPT codes**, which roll up into **Outcome/Quality Reports**.

---

## PART 7 — BILLING CODES EXPLAINED SIMPLY

| Code | Plain-English meaning |
|---|---|
| **99492** | "First month of CoCM management" — the initial setup + first ~70 minutes of BHM time in month 1. |
| **99493** | "Every month after that" — ongoing ~60 minutes/month of BHM time. |
| **99494** | "Add-on" — extra 30-minute blocks of BHM time beyond the base code, same month. |
| **G2214** | Add-on specifically for psychiatric consultant involvement (initial or subsequent), if applicable. |

**Real-life comparison:** it works like a **taxi meter with tiers** — you get billed a flat "pickup fee" for the first chunk of time (99492), then a running per-minute-block rate after that (99493/99494), and there's a separate "toll surcharge" if a specialist (psychiatrist) was involved (G2214). The system's job is to make sure the meter is running *accurately and legally* — hence "no duplicate minutes," "no hard-coded reimbursement," and "claim never released without complete documentation."

---

## PART 8 — SAFETY / ESCALATION LOGIC (The Most Important Rule in the Whole System)

Anywhere a patient is self-reporting symptoms (tablet assessment), the system must:
1. Detect a positive answer to a safety-critical item (e.g., a suicidal-ideation question) **the instant it's answered**, not after the whole form is submitted.
2. **Block** the patient from finishing the routine flow silently — it must interrupt and alert staff (S9's rule).
3. Log **who acknowledged** the alert and when (S13's acceptance criteria — "Provider acknowledgment... logged with timestamp and user ID").
4. Never let this become a fully-automated diagnosis — every screen explicitly labels these as "decision support," not a clinical determination. A human (the PCP) must always make and document the actual decision.

**Real-life comparison:** This is identical in spirit to a **smoke detector wired directly to the fire department** — it doesn't wait for someone to notice smoke and dial 911 manually; it interrupts everything immediately, but a human firefighter still has to show up and make the real call.

---

## PART 9 — ALL POSSIBLE FLOWS / BRANCHES (Decision Tree, Every Path)

```
A) New Practice Signup
   └─ Register → BAA/eSign → Pending Meduvo Approval → Approved → Can access PHI

B) Existing Provider, Routine Visit
   Sign in → Dashboard → Find/Register Patient → Assign Assessment → Hand tablet
     └─ Patient completes → PCP reviews scores
          ├─ No risk flag, score low → PCP may choose "Not this time" → END
          ├─ Score elevated → "Discuss with Patient"
          │     ├─ Patient declines CoCM → decline reason logged → soft follow-up task → END (for now)
          │     └─ Patient accepts → eConsent → Referral created
          │            ├─ BHM available NOW → Live 3-way call → BHM completes intake same day
          │            └─ BHM NOT available → Scheduled follow-up visit booked → referral sits in BHM queue
          └─ SAFETY FLAG present (self-harm item positive)
                └─ Hard stop mid-assessment → immediate staff alert → provider must acknowledge
                     before any further routine action is possible → "Urgent Escalation" path available
                     directly from Screen 6 (Provider Review) in the Product Spec version

C) BHM Ongoing Loop (repeats monthly for as long as patient is enrolled)
   Referral queue → Open chart → Outreach (call/text/portal)
     ├─ Reached → schedule/attend initial or follow-up visit → update care plan → log time
     ├─ Not reached (no answer) → outcome logged → system reminds BHM to retry
   → Repeat-assessment reminder fires at set interval → patient re-takes PHQ-9/GAD-7
     ├─ Improving → continue current plan
     └─ Not improving / risk rising → "Escalate to Psychiatric Consultant"
            → Weekly caseload review (Phase 2) → recommendation → BHM implements
            → PCP notified via dashboard alert (closing the loop back to Screen 3)

D) Billing Cycle (monthly, cuts across everything above)
   Time Ledger accumulates every logged BHM/team minute all month
     → End of month: "Resolve Missing Items" (consent? care plan? enough minutes? psychiatrist availability met?)
        ├─ Something missing → claim blocked, must fix first
        └─ Everything complete → "Release Claim" → claim-ready export under billing NPI

E) Patient Never Consents / Drops Out
   Decline logged at S14 → soft follow-up task created for staff to try again at next visit
   (system does NOT force enrollment; consent refusal is stored without blocking routine care)
```

---

## PART 10 — DEVELOPMENT ROADMAP (What to Build First — Step by Step, 10–15 Day MVP)

This mirrors the spec's own MVP timeline, restated as a build-order a dev team would actually follow:

**Step 1 (Day 1–2): Assessments Engine + Tablet Kiosk UI**
- Why first: nothing else in the system has data to work with until a score exists.
- Build: PHQ-9/GAD-7 question sets, scoring formulas, safety-flag logic, kiosk lockdown mode, auto-save per answer.
- Who uses it: Patient (tablet), indirectly PCP (assigns it).
- Example: a real clinic could test this alone as a "digital clipboard" even before anything downstream exists.

**Step 2 (Day 3–4): Scoring Engine + Results-in-Chart (Provider view)**
- Build: real-time push notification to PCP, score/severity calculation, trend chart, risk banner.
- Who uses it: PCP.
- Example: like a heart-rate monitor pushing a live reading to a nurse's station screen.

**Step 3 (Day 5–6): eConsent + Referral Workflow**
- Build: consent document + signature capture + versioning, one-click referral bundle, BHM auto-assign logic.
- Who uses it: PCP + Patient together.

**Step 4 (Day 7–8): BHM Dashboard**
- Build: referral queue (sorted by risk/due date), patient list, care plan notes.
- Who uses it: BHM.

**Step 5 (Day 9–10): Care Plan & Notes for BHM**
- Build: template library, goals/interventions fields, versioned care plan updates shared back to PCP.

**Step 6 (Day 11–12): Psychiatrist Portal (build the screens even though usage is Phase 2)**
- Build: case review queue, recommendation form, secure routing to BHM+PCP.

**Step 7 (Day 13): Communication Hub + Alerts**
- Build: secure messaging, task notifications across all roles.

**Step 8 (Day 14): Reporting Engine + Time Tracking/Billing basics**
- Build: monthly time ledger, CPT code mapping, completeness checks, claim-ready export, quality/outcome reports.

**Step 9 (Day 15): Testing, Security Review, Deployment**
- RBAC (role-based access control), MFA, encryption in transit/at rest, audit logs, backups, HIPAA compliance checks, BAA signed.

---

## PART 11 — FIELDS MASTER REFERENCE (A–Z Style, Screen by Screen)

| Screen | All Fields on That Screen |
|---|---|
| Practice Onboarding | Practice legal name, TIN/EIN, Billing NPI, BAA & service agreement (eSign) |
| Provider & Contact Setup | First name, Last name, NPI, License number, Email, Phone |
| Provider Sign-In | Practice/Org selector, Email/Username, Password, Remember-device checkbox, MFA code |
| Dashboard | Active CoCM patients count, Assessments this month, Patients due follow-up, Alerts count, Schedule list, Caseload summary donut chart |
| Patient Search/Add | Search box, First/Last name, DOB, Gender/Sex, Phone, Email, Insurance/Payer, PCP of record |
| Assign Assessment | Instrument checklist (PHQ-9/GAD-7/PROMIS/AUDIT-C/custom), Visit reason/notes, Tablet selector |
| Patient Check-in (Tablet) | First name, Last name, DOB, Phone, Email, Consent checkboxes (Privacy Notice, CoCM Program Consent, Use of Information) |
| Assessment Question | Instrument name, Question text, Response option (0–3 scale or similar), progress indicator |
| Provider Results Chart | PHQ-9 Score, GAD-7 Score, Risk Level, Score trend graph |
| Clinical Decision/Referral | Recommendation text, Referral reason, Assigned BHM dropdown, "Patient agrees to referral" checkbox |
| Care Plan (Initial) | Goals (list), Next Review date |
| BHM Dashboard | New referrals count, Active count, Due today count, High-risk alerts count, Caseload table (Name, PHQ-9, GAD-7, Risk, Follow-up date) |
| BHM Patient Detail | Name, DOB, Phone, Risk Level, Care Plan Goals, Recent Activity log, "Add Note" |
| Psychiatrist Case Review | Patient, PHQ-9, GAD-7, Risk, Due date, Recommendation text, Follow-up-in dropdown |
| Billing Overview | Total Billed, Total Paid, Pending, Denials, Claim # / DOS / Code / Status / Amount table |
| Reports & Outcomes | Active Patients, Assessments This Month, PHQ-9 Reduction (avg), Response Rate %, Score trend chart, Export date range picker, Report type selector |

*(Every field above maps 1:1 to a field visible on the actual mockup screenshots you supplied — nothing invented, only consolidated in one table for developer convenience.)*

---

## PART 12 — SIMULATION: "A DAY AT COMMUNITY HEALTH PC" (Full Narrative Walkthrough)

> **8:45 AM** — Sarah Johnson checks in for her annual physical. Front desk searches her name in **S4**, finds her MRN 10006 already in the system.
>
> **8:50 AM** — Dr. Doe opens her chart, checks the PHQ-9/GAD-7 boxes in **S5**, and pushes it to Tablet #3. Front desk hands Sarah the tablet **(S6)**.
>
> **8:52 AM** — Sarah confirms her identity on the kiosk **(S7)**, reads the privacy note **(S8)**, and answers 9+7 questions **(S9)**. On question 9 of the PHQ-9 ("thoughts of being better off dead"), she answers "Several days" — not a hard stop (that's reserved for the more severe answer), but it still feeds into the score.
>
> **8:58 AM** — She reviews and submits **(S10)**, sees the thank-you screen, tablet auto-locks **(S11)**.
>
> **8:58 AM** — Dr. Doe's desktop *immediately* pops a toast: "Sarah Johnson's assessment is ready" **(S12)**. He clicks in and sees: **PHQ-9: 16 (Moderately Severe), GAD-7: 11 (Moderate)** **(S13)**. The system's decision-support panel suggests considering a CoCM referral.
>
> **9:01 AM** — With Sarah still in the room, he turns the screen and shows her the simplified chart **(S14)**, explains what collaborative care means. She says yes.
>
> **9:03 AM** — She signs the consent on the pad **(S15)**. Dr. Doe clicks "Send Referral" and the system auto-assigns Anna Williams, LCSW **(S16)**.
>
> **9:03 AM** — System checks: is Anna online right now? **YES (S17)**. Dr. Doe clicks "Start Live Collaborative Call." Anna joins by video from her office **(S17A)** — she and Sarah talk for 10 minutes while Dr. Doe steps out to see his next patient. Anna types the initial care plan live.
>
> **9:15 AM** — Call ends. The referral is now sitting, already "engaged," in Anna's queue **(S18)** — but she doesn't even need to "begin outreach" since she just did the live intake.
>
> **Two weeks later** — Anna's dashboard reminds her a repeat PHQ-9 is due **(S22)**. She calls Sarah, logs "Reached — mood slightly improved," updates the care plan, logs 22 minutes against CPT 99492.
>
> **6 weeks in** — Sarah's score has only dropped from 16→15. Anna clicks "Escalate to Psychiatric Consultant." *(Phase 2 feature — in the MVP this becomes a manual task/flag instead of a full psychiatrist portal workflow.)*
>
> **End of month** — The practice's billing staff opens the Time Ledger. Sarah's case shows 68 minutes logged, consent on file, care plan updated — the "Release Claim" button lights up green, and 99492 is submitted under Dr. Doe's billing NPI.

---

## PART 13 — AI IMAGE-GENERATION PROMPTS (One Per Module/Flow, Ready to Paste into Midjourney / DALL·E / Whimsical / Figma AI)

> Use these to generate clean workflow diagrams/illustrations for pitch decks, documentation, or Figma inspiration. Written for tools that understand "flat vector diagram" style prompts.

**1. Overall System Architecture**
```
Flat vector infographic, healthcare SaaS system architecture diagram, five horizontal 
swimlanes labeled "Primary Care Provider", "Patient", "Behavioral Health Manager", 
"Psychiatric Consultant", "EMR System" — each lane has 5-6 connected rounded rectangle 
process boxes with arrows flowing left to right, color-coded lanes (navy blue, green, 
orange, purple, dark blue), small line-icons inside each box (clipboard, tablet, phone, 
chart, lock), clean corporate medical style, white background, minimalist, 16:9
```

**2. Patient Tablet Assessment Flow**
```
Flat vector UI flow diagram, 5 connected mobile/tablet mockup screens in a horizontal 
row connected by arrows, screens show: identity confirmation with checkmark icon, 
privacy/instructions screen, question-and-multiple-choice-answer screen with a progress 
bar, review-and-submit confirmation screen, thank-you lock screen, green medical color 
palette, soft rounded corners, isometric-style shadows, clean SaaS product design, white 
background
```

**3. Safety Escalation Logic**
```
Flat vector diagram, warning/alert flow, a tablet icon at top with a red exclamation 
triangle branching down to a "STOP" shield icon, then an arrow to a bell/notification 
icon labeled "Immediate Clinician Alert", then to a checkmark icon labeled "Provider 
Acknowledgment Logged", orange and red accent colors on white background, medical 
safety infographic style, minimal icons, clear directional arrows
```

**4. Referral & Real-Time BHM Availability Decision**
```
Flat vector decision-tree diagram, a diamond-shaped decision node in the center labeled 
"BHM Available Now?", two paths branching: left path (green, labeled YES) leads to a 
3-person video-call icon labeled "Live Collaborative Call", right path (orange, labeled 
NO) leads to a calendar icon labeled "Schedule Follow-Up Visit", both paths merge into a 
single inbox/queue icon at the bottom labeled "BHM Referral Queue", clean corporate 
health-tech style, navy and orange color scheme, white background
```

**5. BHM Ongoing Case Management Loop**
```
Flat vector circular/loop process diagram, four icons arranged in a circle connected by 
curved arrows forming a continuous loop: a notepad icon labeled "Progress Notes", a 
clock/reminder icon labeled "Repeat Assessment", a stopwatch icon labeled "Time 
Tracking", an alert-escalation icon labeled "Escalate if Needed", orange color theme, 
circular flow with arrowheads, minimalist medical SaaS illustration, white background
```

**6. Psychiatrist Weekly Case Review (Phase 2)**
```
Flat vector diagram, a purple-themed doctor-at-desk icon reviewing a stack of digital 
case files on a monitor, arrow pointing to a "Treatment Recommendation" document icon, 
then two arrows branching out to a "BHM" icon and a "PCP" icon, weekly-calendar icon in 
the corner, clean isometric illustration style, purple and white color palette, 16:9 
aspect ratio
```

**7. Billing & Time Ledger Flow**
```
Flat vector infographic, a taxi-meter-style icon at the left labeled "Time Ledger", 
arrow to a checklist icon labeled "Documentation Completeness Check" with sub-items 
(consent, care plan, minutes, psychiatric availability), arrow to a green "Release 
Claim" button icon, arrow to a document/export icon labeled "Claim-Ready Export", 
gold/green accent colors for money and billing theme, clean corporate finance-meets-
healthcare illustration, white background
```

**8. Full Patient Journey (Hero Diagram for Pitch Deck)**
```
Wide horizontal flat vector infographic, a single winding path/road connecting 12 
milestone icons representing a patient's journey: check-in desk, tablet, chart with 
upward trend line, handshake/consent icon, video call icon, calendar, phone call icon, 
care plan document, repeat-cycle arrows, psychiatrist icon, billing/receipt icon, 
improved-health checkmark/heart icon at the end, alternating navy blue and orange 
accent dots along the path, corporate healthcare pitch-deck illustration style, plenty 
of white space, 21:9 aspect ratio
```

**9. Role/Actor Map**
```
Flat vector diagram, four circular avatar icons arranged around a central rounded 
rectangle labeled "Meduvo Health CoCM Platform" — avatars labeled "Primary Care 
Provider" (navy), "Patient" (green), "Behavioral Health Manager" (orange), "Psychiatric 
Consultant" (purple), each avatar connected to the center hub with a double-headed 
arrow showing two-way data flow, small icons above each avatar hinting at their tool 
(stethoscope, tablet, headset, prescription pad), clean modern healthcare branding 
style, white background
```

---

## PART 14 — THINGS NOT EXPLICITLY ASKED BUT IMPORTANT TO KNOW (Gaps, Risks & Recommendations)

1. **Payer qualification is NOT automated.** The spec explicitly says the MVP does not pretend to auto-determine Medicare/insurance eligibility for CoCM billing — a human still verifies this. Don't build false confidence into the UI here.
2. **Phase 2 vs MVP boundary matters a lot.** Screen 23 (Psychiatrist Weekly Review) is explicitly *referenced but out of MVP build scope* — many teams accidentally over-build this first. Build it last, or as a stub.
3. **HIPAA/BAA is a legal gate, not just a checkbox.** No PHI access is allowed until Meduvo (the platform admin) manually approves a new practice account — this needs an internal admin-approval screen that isn't shown in either deck but must exist.
4. **Duplicate-time and overlapping-activity prevention** is a real billing-fraud risk area (two BHMs both logging minutes on the same patient in the same window) — this needs explicit backend validation, not just trust in the UI.
5. **Consent refusal must not block routine care** — this is a compliance requirement (a patient can say "no" to CoCM and still get normal treatment) — make sure the referral decline path never accidentally locks the patient record.
6. **The tablet "kiosk mode"** needs real device-management software (like an MDM — Mobile Device Management — profile), not just a web page in fullscreen, or patients can accidentally exit and see the next patient's data.
7. **Auto-assign load balancing for BHM** needs a defined algorithm (round robin? by current caseload count? by risk-severity match?) — the mockups show the button but not the underlying rule; this must be designed before building.
8. **The "escalate to psychiatric consultant" button exists in the MVP UI even though the psychiatrist portal itself is Phase 2** — so in the true MVP, clicking it should probably just create an internal task/notification rather than route to a non-existent portal.
9. **Every score-severity threshold** (what counts as "Moderate" vs "Moderately Severe" for PHQ-9, what triggers the safety hard-stop) needs to be configurable per practice/clinical protocol, not hard-coded, since practices may follow slightly different clinical guidelines.
10. **Data retention & multi-language support** are hinted at (language selector on S8) but not specified — decide supported languages early since translated, *clinically validated* versions of PHQ-9/GAD-7 must be used (you cannot just auto-translate a validated clinical instrument).

---

## PART 15 — Roman Urdu Summary (Mukammal Wazahat)

Ye poori cheez ek **healthcare software** hai jiska naam **Meduvo Health CoCM Platform** hai. Iska maqsad ye hai k jab koi patient apne **family doctor (PCP)** k pas jaye aur usko depression ya anxiety ho, to us patient ko sirf "kisi aur ke pas ja k dikhao" nahi bola jata — balke doctor ke apne clinic ke andar hi ek poori team us patient ka ilaj shuru kar deti hai. Ye model duniya bhar mein **CoCM (Collaborative Care Model)** kehlata hai aur Medicare (US ka government insurance) is ke liye alag se paisay deta hai — is liye ye software billing bhi khud track karta hai.

**Char (4) main log is system mein hain:**
1. **PCP (Doctor)** — patient ko dekhta hai, screening assign karta hai, result dekh kar refer karta hai.
2. **Patient** — tablet par chhota sa form bharta hai (PHQ-9 aur GAD-7 naam ke standard sawalnaame, jaise "pichle 2 hafton mein aap kitni dafa udaas rahe").
3. **BHM (Behavioral Health Manager)** — ek care-manager (social worker jaisa banda) jo patient ko baar baar phone karta hai, uska case follow karta hai, jaise ek call-center agent apna ticket follow karta hai.
4. **Psychiatrist Consultant** — ye patient se seedha nahi milta, balke hafte mein ek dafa saaray mushkil cases ka chart dekh kar advice deta hai — bilkul waise jaise ek senior doctor sirf reports dekh kar guidance deta hai bina patient ko dekhe.

**Poora flow yun chalta hai:**
Patient check-in karta hai → tablet pe form bharta hai → turant score calculate hota hai → doctor ko real-time notification jati hai → doctor patient ko result dikhata hai → agar patient razi ho to consent form pe sign karta hai → doctor ek "referral" bhejta hai BHM ko → system check karta hai k BHM abhi available hai ya nahi → agar available hai to turant 3-way video call ho jati hai (doctor + patient + BHM) usi waqt, patient ke jaane se pehle → agar available nahi to appointment book ho jati hai → BHM phir mahine bhar patient ko follow karta rehta hai, dobara test leta hai, agar improvement na ho to psychiatrist ko escalate karta hai → aakhir mein practice ka billing staff mahine ke end pe time-ledger check karta hai aur agar sab kuch (consent, care plan, minutes) mukammal ho to insurance claim submit karta hai.

**Sab se important cheez "Safety Rule" hai:** Agar patient tablet pe koi aisa jawab de jo self-harm (khud ko nuksan pohanchane) ki taraf ishara kare, to system foran us patient ko age nahi jaane deta aur staff ko turant alert kar deta hai — bilkul aise jaise smoke detector fire brigade ko khud call kar deta hai bina kisi insaan ke bataye.

**7 modules jo banane hain:**
1. Assessments Engine (sawalnaame aur scoring)
2. PCP Dashboard (doctor ka control panel)
3. Referral & eConsent (refer karna aur razamandi lena)
4. BHM Dashboard (case manager ka kaam ka panel)
5. Psychiatrist Portal (ye phase 2 mein banega, pehle nahi)
6. Collaborative Hub (sab ke beech messaging)
7. Reports & Billing (paisay aur outcomes ki report)

**Banane ka tarteeb (order):** Pehle assessment/scoring engine banao (kyunke baqi sab isi data pe chalta hai), phir doctor ka dashboard, phir consent/referral, phir BHM ka panel, phir care-plan, phir psychiatrist portal (skeleton), phir messaging, aakhir mein reporting/billing, aur sab se aakhir mein security-testing (MFA, encryption, HIPAA compliance).

**Har screen ki fields** upar tables mein A-to-Z detail se di gayi hain — misal ke taur pe patient register karne wali screen mein: Name, DOB, Sex, Phone, Insurance, PCP ka naam waghera hote hain.

**AI se diagrams banwane k liye prompts** bhi upar Part 13 mein diye gaye hain — inko copy karke Midjourney, DALL-E, ya kisi bhi AI image tool mein daal kar aap har module ka professional flow-diagram bana sakte hain (jaise overall architecture, patient tablet flow, safety-escalation diagram, billing flow, waghera).

**Jo cheezein aapne nahi poochi lekin important hain (Part 14 mein detail hai):**
- Insurance/payer eligibility khud check nahi hoti — insaan ko manually verify karna hoga.
- Psychiatrist wala poora portal abhi MVP mein nahi banega — sirf ek button/task hoga.
- Practice ko approve karne se pehle koi bhi PHI (patient data) access nahi kar sakta — is ke liye ek admin-approval system bhi banana zaroori hai jo screens mein direct nahi dikhaya gaya lekin implicit hai.
- Do BHM ek hi patient pe overlapping time na likh dein — is ki backend validation zaroori hai (warna billing fraud ho sakta hai).
- Consent na dena patient ka haq hai — aur is se uska normal ilaj rukna nahi chahiye.
- Tablet ko sahi "kiosk mode" mein lock karna zaroori hai warna ek patient ka data doosre patient ko nazar aa sakta hai.

Agar aap chahen to main is poore document ko ek **Word (.docx)** file ya **PowerPoint (.pptx)** presentation mein bhi convert kar sakta hoon, ya phir har module ka individual diagram bhi bana sakta hoon (Mermaid/flowchart) — bata dein.