Difference between revisions of "Care Goals & Decision Making"

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[[Care Goals & Decision Making]] are elements of the [[Care Management Determinants|Care Management]] [[Determinants]] that are that can decisively affect [[Patient Well-Being|patient well-being]] and [[Patient Recovery|patient recovery]].  
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[[Care Goals & Decision Making]] are elements of the [[Care Management Determinants|Care Management]] [[Determinants]] that are that can decisively affect [[Patient Well-Being|patient well-being]] and [[Patient Recovery|patient recovery]]. [[Care Goals & Decision Making|Care Goals]] include a listing of [[symptoms]] (S Codes) and [[determinants]] (D Determinants) that the [[Care Plan]] is developed to improve.  
  
[[Care Goals & Decision Making|Care Goals]] include a listing of [[Symptoms]] and [[determinants]] that the [[Care Plan]] is developed to improve.  
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==Diagnosis Codes==
 
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These are listing of impactable [[Physical Conditions]] and [[Mental Health Conditions]] [[determinants]] (D Codes) that the patient and providers are trying to improve with the [[Care Plan]]. These are found in the patient's Medical Record. 
==Health Biomarkers==
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==Physical and Mental Health Biomarkers==
These are listing of [[Physical Health]] and [[Mental Health]] Determinants that the patient and providers are trying to improve. These are found in the patient's Medical Record in support of the diagnosis codes.   
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These are listing of impactable [[Physical Conditions]] and [[Mental Health Conditions]] [[determinants]] (D Codes) that the patient and providers are trying to improve with the [[Care Plan]]. These biomarkers are typically found in the patient's Medical Record in support of the diagnosis codes.   
 
* Blood Pressure, HbA1C blood test, cholesterol, etc.
 
* Blood Pressure, HbA1C blood test, cholesterol, etc.
 
* Depression, Anxiety, etc.
 
* Depression, Anxiety, etc.
==Diagnosis==
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==[[Symptoms]]==
* Testing
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These are listing of the patient provided [[symptoms]] that the patient and providers are trying to improve with the [[Care Plan]]. These are provided by the patient via the [[Well-Being Assessment|Patient Well-Being Assessment]] or the [[Well-Being Status|Patient Well-Being Status]]. 
==Goals==
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==[[Functional Conditions|Functional Limitations]]==
* Clinical Conditions
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These are listing of the patient provided [[Functional Conditions|Functional Limitations]] that the patient and providers are trying to improve with the [[Care Plan]]. These are provided by the patient via the [[Well-Being Assessment|Patient Well-Being Assessment]] or the [[Well-Being Status|Patient Well-Being Status]].
* Functional Conditions
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==Quality of Life Limitations==
* Behavioral & Lifestyle
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These are listing of the patient provided '''Quality of Life''' Limitations that the patient and providers are trying to improve with the [[Care Plan]]. These are provided by the patient via the [[Well-Being Assessment|Patient Well-Being Assessment]] or the [[Well-Being Status|Patient Well-Being Status]].
* Home
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* [[Activity Determinants|Activities]]
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* [[Socioeconomic Determinants|Socioeconomic]]
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* Purpose
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* Competence
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* Connections
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==Preferences==
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* Treatment Preferences - Home Based, Recovery Team, Technology Use, Palliative Care and End of Life preferences
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* Authorizations - Privacy and HIPAA, Advanced Beneficiary Notice, Recovery Team Access to Electronic Medical Records
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* Living Will - Advanced Patient Directives

Latest revision as of 10:26, 27 May 2015

Care Goals & Decision Making are elements of the Care Management Determinants that are that can decisively affect patient well-being and patient recovery. Care Goals include a listing of symptoms (S Codes) and determinants (D Determinants) that the Care Plan is developed to improve.

Diagnosis Codes

These are listing of impactable Physical Conditions and Mental Health Conditions determinants (D Codes) that the patient and providers are trying to improve with the Care Plan. These are found in the patient's Medical Record.

Physical and Mental Health Biomarkers

These are listing of impactable Physical Conditions and Mental Health Conditions determinants (D Codes) that the patient and providers are trying to improve with the Care Plan. These biomarkers are typically found in the patient's Medical Record in support of the diagnosis codes.

  • Blood Pressure, HbA1C blood test, cholesterol, etc.
  • Depression, Anxiety, etc.

Symptoms

These are listing of the patient provided symptoms that the patient and providers are trying to improve with the Care Plan. These are provided by the patient via the Patient Well-Being Assessment or the Patient Well-Being Status.

Functional Limitations

These are listing of the patient provided Functional Limitations that the patient and providers are trying to improve with the Care Plan. These are provided by the patient via the Patient Well-Being Assessment or the Patient Well-Being Status.

Quality of Life Limitations

These are listing of the patient provided Quality of Life Limitations that the patient and providers are trying to improve with the Care Plan. These are provided by the patient via the Patient Well-Being Assessment or the Patient Well-Being Status.

Preferences

  • Treatment Preferences - Home Based, Recovery Team, Technology Use, Palliative Care and End of Life preferences
  • Authorizations - Privacy and HIPAA, Advanced Beneficiary Notice, Recovery Team Access to Electronic Medical Records
  • Living Will - Advanced Patient Directives