Stream: implementers
Topic: patient goals
Hanne Vuegen (Nov 16 2020 at 08:01):
Hello everybody,
In order to make care more patient & goal oriented we need to listen to the patient and what is important to them instead of giving everybody the same standard care. Is there a specific FHIR resource that can be used to registrate 'patients goals' or do we use the GOAL resource? I think the GOAL to be more care related. Life goals on the other hand are difficult to structure..
I explain myself:
If a person that is suffering diabetes lives towards weekly dates with her friends to play cards and EAT CAKE, his/her treatment should be adapted in this way that it is still possible to participate in these dates (let's say to prevent depression).
This information, a 'patient narrative' or what we call 'life goals' are very important to know but not always on the agenda of health care actors. We need to establish a workflow in which it becomes naturally for care actors to ask about these things, or even make it possible that patients can add this by themself in a careplan. But which FHIR resource should be used then? Anybody has some ideas/experiences?
Thank you!
Kr,
Hanne
Hanne Vuegen (Nov 16 2020 at 08:51):
@Jose Costa Teixeira
Jose Costa Teixeira (Nov 16 2020 at 10:18):
I think Goal should be the resource to use, but indeed Goal seems to be care-focused. Any ideas?
@Michelle (Moseman) Miller @Emma Jones @Derek Ritz , others?
René Spronk (Nov 16 2020 at 10:45):
Certainly for Condition its use is entirely up to the author of that Condition, and some Conditions may be relevance to some parties (e.g. patients) whereas other parties may not care about that issue. Example I use in training courses is someone being concerned about losing their hair.
Given the tight links between Condition, Goal and CarePlan I'd fully expect the same sort of flexibility of usage. After all, it's pretty arrogant for one party to state that someone's concern is of no relevance, or that it should not be captured.
Lloyd McKenzie (Nov 16 2020 at 13:04):
Goal can represent the goals expressed by different stakeholders - practitioner, patient or related person. Goal.description.text can express goals as free text. There's an extension that allows the capture of 'acceptance' of a stated goal by other stakeholders. It's entirely possible that different stakeholders will have different goals. What the provider wants, the mom wants and the patient wants could all be in conflict. Still worth documenting.
Derek Ritz (Nov 16 2020 at 20:59):
Hanne Vuegen said:
In order to make care more patient & goal oriented we need to listen to the patient and what is important to them instead of giving everybody the same standard care.
This is an insightful comment. Of course... insofar as goals may relate to care guidelines... a key goal of the operators of a care delivery network (e.g. an HMO, or a jurisdictional government that operates a publicly-funded care network, or VHA, etc.) is to try to operationalize guideline-adherent care as far as it is possible to do so. Improved guideline-adherence leads, as the literature shows, to improved population health outcomes.
It is natural to have a tension between a smoker that enjoys smoking (and so wants to keep doing it) or a person that enjoys eating cake (and wants to keep doing it) and a clinician that is trying to help that person to become more healthy. I'm not sure the role of informatics in addressing this tension -- except to faithfully record the information and attribute it to the correct author.
Last updated: Apr 12 2022 at 19:14 UTC
