Patient Records Plugin for Veterinary Clinics

A Cowork plugin for small independent veterinary clinics to generate informed by AVMA guidelines SOAP notes, vaccination records, discharge instructions, and patient history summaries with professionally structured domain knowledge from AVMA, AAHA, AAFP, Plumb's, and WSAVA guidelines — without expensive practice management software.

Important: All documents generated by this plugin are drafts intended as starting points. Clinical and healthcare documents must be reviewed by a qualified healthcare professional before use. This plugin does not provide medical advice and is not a substitute for professional clinical judgment. Ensure all output complies with your organization's HIPAA policies and applicable regulations.

Installation

1. Download the pf-patient-records.plugin file
2. Open Claude Desktop and navigate to Settings > Plugins
3. Click Install Plugin and select the downloaded .plugin file
4. The plugin will be installed and available immediately

Note: All data stays local on your machine. No external API calls or cloud storage required.

Features

• SOAP Note Generation: Transform clinical observations into formatted AVMA-standard SOAP notes
• Vaccination Records: Create professional vaccination certificates with lot tracking
• Discharge Instructions: Generate client-friendly post-visit care instructions
• Patient History Synthesis: Automatically compile multi-visit patient histories
• Patient Status Dashboard: Quick lookup of patient vaccination status and pending follow-ups
• Local File-Based: All records stored locally as DOCX files — no cloud dependency
• No Per-Vet Pricing: Unlimited users in your clinic at no additional cost

Cost Displacement

Alternative to expensive practice management systems:

• Shepherd Veterinary: $3,588/year per vet
• Digitail: $1,800–$4,800/year
• eVetPractice (Covetrus Pulse): $4,188/year per vet

This plugin provides documentation-only workflows for Included with your subscription.

Quick Start

1. Initialize Workspace

/patient patient-setup

This creates:

• Patient register (CSV)
• Clinic configuration
• Workspace folders (inbound, processing, outbound, archive)

2. Generate Your First SOAP Note

/patient soap

Follow the conversation to enter clinical observations, then generate a formatted DOCX.

3. Create Vaccination Record

/patient vaccine

Enter vaccine type, lot number, expiry date, and next-due date.

4. Generate Discharge Instructions

/patient discharge

Create client-friendly post-visit instructions with medication, activity restrictions, and warning signs.

5. Synthesize Patient History

/patient history

Automatically compile all prior SOAP notes into a summary document (24-month default window).

Commands

Command	Purpose	Output
/patient setup	Initialize workspace	Folders, patient register, clinic config
/patient soap	Generate AVMA SOAP note	soap-note-{ID}-{DATE}-{TIME}.docx
/patient vaccine	Create vaccination record	vaccine-record-{ID}-{DATE}-{TIME}.docx
/patient discharge	Generate discharge instructions	discharge-{ID}-{DATE}-{TIME}.docx
/patient history	Synthesize patient history	history-{ID}-{DATE}-{TIME}.docx
/patient status	View patient/clinic status	Console output (no file)
/patient run	Full workflow (SOAP → discharge)	SOAP note + discharge instructions

Workflow

Single-Visit Documentation (SOAP + Discharge)

1. Run /patient soap
   → Collect chief complaint, findings, diagnosis, plan
   → Generate formatted SOAP note DOCX
   ↓
2. Run /patient discharge
   → Use SOAP findings to create client instructions
   → Generate discharge instructions DOCX
   ↓
3. Review, sign, and file documents

Multi-Visit Patient Management

Visit 1: Generate SOAP note + discharge instructions
Visit 2: Generate SOAP note + discharge instructions
Visit 3: Run /patient history → synthesize all 3 visits into summary

Folder Structure

workspace/
├── inbound/           ← Place raw clinical notes or lab results
├── processing/        ← Temporary workspace during generation
├── outbound/          ← Generated DOCX files (review before filing)
├── archive/           ← Completed and signed records (BACKUP REGULARLY!)
└── .patient/
    ├── patient-register.csv    ← Master patient list
    ├── clinic-config.json      ← Clinic settings
    └── README.md

Important: Legal Compliance

Disclaimer Requirement

Every generated document includes the exact disclaimer:

AI-ASSISTED DRAFT — Review and counter-sign by licensed veterinarian before filing

This is mandatory. AI-generated documents are NOT official medical records until reviewed and signed by a licensed veterinarian.

Medical Record Retention

State veterinary practice acts require medical records to be retained for 3-7 years. Backup your archive/ folder regularly to prevent data loss.

AVMA Reference Standards

SOAP notes follow AVMA (American Veterinary Medical Association) standards for medical record documentation. Ensure all S-O-A-P sections are logically consistent and clinically sound.

Data Privacy & Security

• Local-only storage: All patient records stay on your clinic computers — local processing
• No vendor lock-in: Export records as DOCX files anytime
• No patient data sharing: Plugin does not transmit patient information to external services
• File-based: No database encryption to manage — standard DOCX encryption available if needed

AI-Powered Features

• informed by AVMA guidelines SOAP Note Generation: Transforms clinical observations into formatted Subjective-Objective-Assessment-Plan SOAP notes meeting veterinary standards
• Multi-Visit Patient History Synthesis: Automatically compiles and analyzes all prior SOAP notes into comprehensive patient summaries with clinical trends
• Vaccination Status Tracking: Generates vaccination records with lot number tracking, expiration dates, and next-due reminders
• Discharge Instruction Customization: Creates client-friendly post-visit care instructions automatically adapted to clinical findings
• Clinical Trend Analysis: Identifies recurring conditions and patterns across patient visits over customizable time windows
• Patient Timeline Organization: Structures visit data chronologically and flags urgent follow-up items and clinical concerns
• Species-Specific Vital Range Validation: Automatically flags vitals outside normal ranges per Merck Veterinary Manual 12th ed. for canine, feline, rabbit, and avian patients
• Drug Dosing Verification: Cross-references prescribed medications against Plumb's Veterinary Drug Handbook 10th ed. common dosing ranges with automatic outlier flagging
• AAHA/AAFP Vaccination Protocol Compliance: Classifies vaccines as core vs non-core per AAHA (2022) and AAFP (2020) guidelines with auto-suggested booster intervals
• Evidence-Based Emergency Triage Criteria: Three-tier warning system (Emergency/Urgent/Monitor) based on RECOVER CPR Initiative and veterinary emergency protocols
• IRIS CKD Staging Integration: Displays International Renal Interest Society kidney disease staging (Stages 1-4) in patient status views
• Chronic Disease Monitoring Protocols: Tracks diabetes (AAHA 2018), CKD (IRIS), hypothyroidism, and osteoarthritis with evidence-based monitoring intervals
• Medication Interaction Detection: Flags high-risk drug combinations (NSAIDs+corticosteroids, tramadol+SSRIs, etc.) per Plumb's Drug Interaction references
• Feline Safety Alerts: Species-specific contraindication detection including acetaminophen toxicity, permethrin toxicity, and FISS injection-site sarcoma prevention per AAFP/VAFSTF

Feature Comparison

Feature	Patient Records Plugin	Shepherd ($3,588/yr)	Digitail ($1,800-4,800/yr)	eVetPractice ($4,188/yr)
AVMA SOAP notes	✅	✅	✅	✅
Vaccination records with AAHA/AAFP compliance	✅	Partial	Partial	Partial
Drug dosing validation (Plumb's)	✅	❌	❌	❌
Species-specific vital flagging	✅	❌	❌	❌
FISS injection-site tracking	✅	❌	❌	❌
IRIS CKD staging	✅	❌	❌	❌
Emergency triage criteria (RECOVER)	✅	❌	❌	❌
Drug interaction warnings	✅	❌	❌	❌
Local data storage	✅	❌ Cloud	❌ Cloud	❌ Cloud
Per-vet pricing	Free	$3,588/vet	$1,800+/vet	$4,188/vet
Offline capable	✅	❌	❌	❌

Limitations

No Real-Time Database

• Records stored as local DOCX files + CSV register
• Workaround: Export CSV register for analysis or reminder campaigns

No API Integrations

• Cannot auto-pull lab results from IDEXX or other PIMS
• Workaround: Copy-paste lab values into SOAP form

No Background Processing

• All operations run during active Cowork sessions
• Workaround: All outputs saved to outbound/ for immediate access

No Live Scheduling

• Cannot send vaccination reminders or appointment confirmations
• Workaround: Export patient register for use with external email tools

24-Month History Window

• Patient history synthesis defaults to 24 months (to preserve context)
• Older records can be retrieved manually from archive/

Estimated Cost per Use

Disclaimer: Token estimates are approximate and based on typical usage patterns measured from skill prompt sizes. Actual costs vary with input data size, conversation length, and complexity. Estimates use Claude Sonnet 4.6 pricing ($3/1M input, $15/1M output). Cowork and Claude Desktop subscription users (Pro/Max/Team) are not charged per-token — these estimates apply only to direct Anthropic API usage. Running stages individually in fresh sessions uses fewer input tokens than running the full pipeline sequentially, because pipeline mode accumulates conversation history across stages.

Per skill (run individually in a fresh session):

Stage	Skill Prompt	User Input	Total Input	Output	Est. Cost
patient-history	~6.2K	~800	~10.5K	~6.0K	~$0.12
patient-vaccine	~2.4K	~800	~6.7K	~3.0K	~$0.06
vtp-med-schedule	~3.5K	~800	~7.1K	~3.5K	~$0.07
vtp-estimate	~3.2K	~800	~6.8K	~3.2K	~$0.07
patient-discharge	~5.4K	~800	~9.8K	~5.4K	~$0.11
vtp-care-plan	~3.1K	~800	~6.7K	~3.1K	~$0.07
patient-soap	~4.7K	~800	~9.5K	~4.7K	~$0.10
Standalone total			~57.0K	~28.9K	~$0.61

Full pipeline (all stages in one session — context accumulates):

Stage	Base Input	+ History	Total Input	Output	Est. Cost
patient-history	~10.0K	0	~10.0K	~6.0K	~$0.12
patient-vaccine	~6.2K	~6.8K	~13.0K	~3.0K	~$0.08
vtp-med-schedule	~7.3K	~10.6K	~17.9K	~3.5K	~$0.11
vtp-estimate	~7.0K	~14.9K	~21.9K	~3.2K	~$0.11
patient-discharge	~9.2K	~18.9K	~28.1K	~5.4K	~$0.17
vtp-care-plan	~6.9K	~25.1K	~32.0K	~3.1K	~$0.14
patient-soap	~8.5K	~29.0K	~37.5K	~4.7K	~$0.18
Pipeline total			~160.6K	~28.9K	~$0.92

Running the full pipeline once typically costs $0.64–$1.19 in API tokens (Claude Sonnet 4.6).

Requirements

• Python 3.8 or later
• python-docx 0.8.11 (auto-installed during setup)
• Cowork session (to access workspace)

Troubleshooting

"patient-register.csv not found"

→ Run /patient setup to initialize the workspace first.

"Duplicate patient_id found"

→ Edit .patient/patient-register.csv to remove duplicate rows.

"python-docx not installed"

→ Run pip install python-docx==0.8.11

SOAP note not generating

→ Check that all required fields are filled in (chief complaint, diagnosis, plan). → Verify patient exists in register before generating document.

Support

For issues or feature requests, contact your Cowork admin or refer to USER-GUIDE.md for detailed instructions.

Important Disclaimers

• AI-Generated Content: This plugin uses AI (LLM) technology which can produce inaccurate or incomplete outputs. All content should be treated as a starting point and reviewed for accuracy before use.
• Not Professional Advice: Outputs do not constitute legal, financial, tax, medical, or other professional advice. Consult qualified professionals before making decisions based on generated content.
• No Compliance Guarantee: References to industry standards, regulations, or guidelines are for informational purposes only. This plugin does not guarantee compliance with any law or regulation. Users are responsible for verifying all outputs meet their specific regulatory requirements.
• No Endorsement or Affiliation: Mention of third-party products, standards, or organizations does not imply endorsement, partnership, or certification by those entities.
• Not Medical or Health Advice: Health and medical-related outputs are not a substitute for professional medical advice, diagnosis, or treatment. Always consult a licensed healthcare provider for health-related decisions.