# Check in with every chronic care patient, not just the ones who call > Each patient in the program has a recurring check-in Task, each contact is logged when it happens, and the unreached stand out. Markdown view of https://www.tabflows.com/university/playbooks/chronic-care-check-ins — the HTML page is canonical. [](https://www.tabflows.com/university/playbooks) 1. [Playbooks](https://www.tabflows.com/university/playbooks) 2. [Patient Follow-Up](https://www.tabflows.com/university/playbooks#patient-follow-up) Each patient in the program has a recurring check-in Task, each contact is logged when it happens, and the unreached stand out. - Elation - Saves about 1 hr per week (est.) Last checked Oct 27, 2026 against Tabflows v3.10.63 ## The situation Chronic care management is recurring monthly work: outreach to eligible patients, care plan updates, medication reconciliation and accurate time logging, which supports patient care and, where it applies, billing documentation. Chronic care management rarely fails because someone forgets a patient has diabetes. It fails because the monthly cadence is hard to hold in memory: contact every eligible patient, update the care plan, log the time. Nothing outside the clinic prompts it, so it loses to same-day urgent work, and by the last week of the month there are more patients left than time to reach them. Two things slip. Outreach narrows to whoever calls in, and the patients with less support quietly stop getting the same contact. And logging gets rushed or batched, then rebuilt from memory later. ## Steps 1. **Start every check-in from one template** Create a task template in Task Settings, under Templates, with a clinic Tag for the program, the program's owner in Assigned to, and checklist items for the contact and for the care plan review. The care plan review stays its own step, separate from the call. 2. **Give each patient in the program a recurring Task** Create a Task from the template for each patient and confirm Patient. Set Repeat to Monthly, or to Custom for another interval, so the next check-in comes back on its own. 3. **Spread the Due on dates across the month** Give patients different Due on dates so a few check-ins surface each day. Sixty patients a month is roughly two or three a day, not a scramble at month end. 4. **Log the contact while it is fresh** Right after each contact, add a comment with what you discussed, any change to the care plan and how long it took. Check the care plan item only when the plan was actually reviewed. 5. **Flag the patients you cannot reach** When a patient has gone two months without a successful contact, say so in Comments and @ mention the teammate who leads the program. Plan a different kind of outreach, not another attempt like the ones that did not work. 6. **See who is still waiting for contact** Save a filter for the program's Tag and the To do status under Favorite filters. It shows who has not been reached yet, without cross-checking a spreadsheet against a call log. The eligible list changes every month, so at the start of each month compare it with this filter and add a Task for anyone new. ## The outcome Every patient in the program gets steady contact, not just the ones who call in. Each touchpoint is written down when it happens, so nothing has to be rebuilt from memory, and the program does not quietly shrink to serving only the most proactive patients on the panel. ## Ask Sidekick Sidekick is the AI assistant inside Tabflows. Hey Tabflows, create a check-in task for each patient I list from our chronic care program, assigned to me, with checklist items for the contact and the care plan review, and spread their due dates across this month. ## In the Product Library - [How do I create and use task templates](https://www.tabflows.com/university/library/tasks/how-do-i-create-and-use-task-templates) - [Break larger tasks into subtasks](https://www.tabflows.com/university/library/tasks/break-larger-tasks-into-subtasks) - [Collaborate on tasks with comments and mentions](https://www.tabflows.com/university/library/tasks/collaborate-on-tasks-with-comments-and-mentions) - [How do I save and reuse a task filter](https://www.tabflows.com/university/library/tasks/how-do-i-save-and-reuse-a-task-filter) - [Using Elation with Tabflows](https://www.tabflows.com/university/library/integrations/using-elation-with-tabflows) [Read the full guide](https://www.tabflows.com/blog/chronic-care-management-task-tracking) [Open it in the Automation catalog](https://www.tabflows.com/university/automations?automation=chronic-care-check-ins) ## Related markdown Section index: [Playbooks](https://www.tabflows.com/university/playbooks.md) Alongside this page: - [Advance directive tracking](https://www.tabflows.com/university/playbooks/advance-directive-tracking.md) - [After hours answering service](https://www.tabflows.com/university/playbooks/after-hours-answering-service.md) - [After hours message triage](https://www.tabflows.com/university/playbooks/after-hours-message-triage.md) - [Billing decline follow up](https://www.tabflows.com/university/playbooks/billing-decline-follow-up.md) - [Call follow up loop](https://www.tabflows.com/university/playbooks/call-follow-up-loop.md) - [Clia and compliance renewals](https://www.tabflows.com/university/playbooks/clia-and-compliance-renewals.md) - [Dea and license renewals](https://www.tabflows.com/university/playbooks/dea-and-license-renewals.md) - [Dme order tracking](https://www.tabflows.com/university/playbooks/dme-order-tracking.md) Start here: - [Tabflows](https://www.tabflows.com/index.md) - [Tabflows pricing](https://www.tabflows.com/pricing.md) - [Tabflows FAQ](https://www.tabflows.com/faqs.md) - [About Tabflows](https://www.tabflows.com/about.md) - [Contact Tabflows](https://www.tabflows.com/contact.md) - [DPC workflow software](https://www.tabflows.com/dpc-workflow-software.md) - [Directory](https://www.tabflows.com/directory.md) - [Workflows](https://www.tabflows.com/workflows.md) - [DPC finder](https://www.tabflows.com/dpc-finder.md) Every page listed in sitemap.xml has a markdown twin at the same URL with `.md` appended, or by sending `Accept: text/markdown` to the canonical URL. Wider index: [llms.txt](https://www.tabflows.com/llms.txt), [llms-full.txt](https://www.tabflows.com/llms-full.txt), [sitemap.md](https://www.tabflows.com/sitemap.md), [sitemap.xml](https://www.tabflows.com/sitemap.xml). Support documentation: https://www.tabflows.com/university/library — append `.md` to any article URL for its raw markdown.