Care Team Assignment System

Three request blocks come in: a patient record with careComplexity, mobilityScore, a conditions list, and care preferences, a facility descriptor, and an availableProviders roster whose roles, specialties, and languages describe who could staff the team.

Care intensity maps one-to-one here: patient.careComplexity values of "high", "medium", and "low" set careTeam.complexityLevel and a teamSize of "3", "2", or "1", and a blank fallback row repeats the low result so a missing complexity value never blocks assignment.

Tiering team size to a three-level complexity flag mirrors how care-management programs size caseloads, with high-complexity patients justifying a multi-provider team while stable ones keep a single clinician. Defaulting the unknown case to the smallest team is a conservative operational choice that avoids over-committing scarce staff before an assessment confirms need.

Age brackets stay minimal: patient.age under 18 maps to "pediatric", under 65 to "adult", and the blank fallback row labels everyone else "senior". Because rows resolve first-match, the middle row effectively covers 18 through 64 without stating both bounds.

The 18 and 65 boundaries are the customary edges of pediatric and geriatric medicine, with 65 also aligning to Medicare eligibility in the US, and the categories translate directly into staffing since the provider table keys on ageCategory to add a geriatric specialist or a pediatrician. Publishing the bracket as its own field keeps that downstream rule readable.

Need flags get precomputed before matching: requiresSpecialist scans patient.conditions for 'diabetes', 'heart_disease', or 'kidney_disease', requiresMentalHealthSupport for 'depression', 'anxiety', or 'ptsd', requiresNutritionSupport for 'obesity', 'diabetes', or 'malnutrition', and mobilityIssues fires when patient.mobilityScore < 50. The same node then nulls patient, availableProviders, and facility, slimming the payload down to the derived flags and the careTeam object.

Collect turns this table into a roster builder: every matching row appends a role, priority, and specialtyFocus entry into careTeam.providers. Complexity picks the backbone, pairing a "primary_physician" with a "nurse_practitioner" at "high" priority for high-complexity patients versus a physician-and-nurse pair at "medium" for lower tiers, while ageCategory == "senior" or "pediatric" adds a "geriatric_specialist" or "pediatrician". Condition rows contribute a "diabetes_specialist", "cardiologist", or "nephrologist" at high priority with a matching specialtyFocus, and the derived flags pull in a "mental_health_provider", "nutritionist", or "physical_therapist".

Team composition tracks the patient-centered medical home model, where a primary clinician and nursing support form the core and specialists attach per condition. Escalating diabetes, cardiac, and renal disease to named specialist roles reflects chronic-disease co-management norms, and staffing physical therapy off a mobility score below 50 or behavioral health off a depression diagnosis mirrors how integrated-care programs plan for functional and mental health needs, not just diagnoses. The priority labels exist for downstream schedulers, not as clinical rankings from any regulation.

Oversight is assigned last: "high" complexity with len(careTeam.providers) > 5 earns a dedicated "care_coordinator" at high priority, any remaining high or medium case gets a "case_manager", and low-complexity teams record "none". First hit ordering means the coordinator row is tested before the broader case-manager row can claim a complex patient.

Adding a coordinator only when the roster exceeds five providers is realistic: fragmentation and handoff risk grow with team size, and absorbing that overhead is what coordination roles in programs like Medicare chronic care management exist to do. Splitting coordinator from case manager by caseload intensity is a sensible operational distinction rather than a regulatory requirement.