Care Coordination

Every handoff, clearly documented

Post-acute care involves multiple clinicians across multiple settings. DocNow's care coordination tools keep the full care team aligned — with shared care plans, referral tracking, and HIPAA-aligned secure messaging in the same platform as the clinical record.

Care coordination network diagram showing patient care team connections

Shared care plans across the team

One care plan, visible and editable by all authorized team members — physicians, wound care nurses, behavioral health clinicians, and physical therapists. Changes are logged with timestamps and attribution, creating a clear record of care decisions.

  • Goal-based care plans with progress tracking
  • Team role-based access controls per care plan section
  • Transition-of-care summaries for discharges and referrals

Referral tracking that closes the loop

Referrals sent from DocNow are tracked until acknowledged. If a receiving provider hasn't responded within the defined timeframe, the system flags the open referral so nothing falls through the gap in a care transition.

  • Direct referral send via Direct Messaging or fax
  • Referral acknowledgment tracking with alert on non-response
  • Referral notes auto-attached to the sending encounter
Key Benefits

Built for multi-clinician post-acute teams

HIPAA-aligned secure messaging within the EHR
Patient portal access for care plan transparency
Shared task lists with ownership assignment
Notification preferences per team member role
Care team roster management with credentials
SNF-to-home transition documentation

See care coordination in the DocNow workflow

Request a demo to see how shared care plans and referral tracking work alongside clinical notes and MIPS reporting.