The bowel watch

The bowel movement log on Health Tracking now watches the gap. The family sets a threshold under Bowel plan on the same card: 24, 36, 48 or 72 hours (48 to start). When the time since the last logged bowel movement passes it, the watch is on. The gap is counted in whole days on the home's clock, so 48 hours reads 2 days and 96 hours reads 4 days; under a day it reads in hours, for example 18 hours. Every logged bowel movement counts, whoever logged it: the family, the professional in the home or a clinician on the care team. A backdated entry counts by the date and time it carries, so logging yesterday's bowel movement today clears the watch when it falls inside the window. Removing an entry re-evaluates the gap. When no bowel movement has ever been logged, the watch counts from the first time the bathroom card was opened or the circle's first symptom entry, whichever is later, and says none has been logged since that day.

What it says is a fact, then the family's own plan, then one request: No bowel movement has been logged for the patient's first name in 2 days (the last one was Oct 2 at 9:30 AM). What the care team said to do: the line the family typed. Ask the care team. The app never names a medicine or a dose on its own, and never says what the gap means; that is the care team's to say.

Where it shows. On Health Tracking, the bathroom card gets an amber block titled Bowel watch above the Log bowel movement button, with two buttons: Log one now puts the cursor in the date and time, and Ask the care team opens the IDC Team feed with the sentence ready in the composer and Notify the team ticked; nothing is posted until you tap Post. The same block is a banner at the top of the Dashboard for the account owner and the caregiver role; it is never a pop-up and never sits over the dose reminder, and the small cross keeps it away for the rest of that day on that device only. The professional on shift sees the same block with the same two buttons at the top of My shifts on the care-team dashboard: Log one now opens the bowel movement log on the Health Tracking tab, Ask the care team opens the Team feed tab the same way. The activity stream carries one line when the watch turns on, Bowel watch followed by the gap, and one when it clears, Bowel movement logged, the watch cleared. Logging a bowel movement clears the block and the banner on the next load.

The alarm. Every 15 minutes the app checks each circle. The first time the threshold is passed, and again every 24 hours while nothing is logged, three things go out. The clinicians who joined the care team get a flagged care-alert line, exactly like a flagged reading: the email carries the sentence, the text says only that a new alert needs a look, the phone notification says A new alert needs a look, and each clinician's own Alerts choice decides, instant or only flagged receive it at once, daily digest carries it in the digest, off receives nothing. The account owner and the caregiver role get a phone notification that says Bowel watch with no name and no number, and an email with the sentence. The professional clocked in at that moment gets the same notification and email. It never goes out twice for the same day on the home's clock. Logging a bowel movement stops it at once, and nothing is sent for the clearing; the activity line is the only trace.

The bowel plan. Under the Last BM line on the bathroom card, Bowel plan opens to the threshold and one line, What the care team said to do when the threshold passes. Type the doctor's standing order or who to call in your own words; the line shows inside the sentence everywhere the watch appears, and in the Home Care Team Plan under Communication and Handoff, in the row Toileting and bowel information, as Bowel plan. The account owner, the caregiver role and a clinician on the care team (a doctor, nurse, therapist or paramedic who joined with a code; not a Home Team aide, never the agency office) can change it; everyone else reads it. The last person to set it is named under the field.

Who sees it: the people who read the symptom log today, the account owner, the caregiver role, the family role, and the care team's logins on the patient. The friends ring and the agency office never see it, and no text, email or notification ever carries the family's plan line to anyone outside that group.