Desired state to be achieved by a patient.

Data Element

Applicable Vocabulary Standard(s)

Patient Goals

Desired outcomes of patient's care.

Data Element

Applicable Vocabulary Standard(s)

Patient Goals

Desired outcomes of patient's care.

SDOH Goals

Identifies a future desired condition or change in condition related to an SDOH risk in any domain and is established by the patient or provider. (e.g., Has adequate quality meals and snacks, Transportation security-able to access health and social needs). SDOH data relate to conditions in which people live, learn, work, and play and their effects on health risks and outcomes.

  • SNOMED International, Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, March 2021 Release
  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.70

Data Element

Applicable Vocabulary Standard(s)

Patient Goals

Desired outcomes of patient's care.

SDOH Goals

Desired future states (e.g., food security) for an identified Social Determinants of Health-related health concern, condition, or diagnosis. (e.g., food insecurity)

  • SNOMED International, Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, March 2022 Release
  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.72

Data Element

Applicable Vocabulary Standard(s)

Patient Goals

Desired outcomes of patient's care.

SDOH Goals

Desired future states for an identified Social Determinants of Health-related health concern, condition, or diagnosis. Examples include but are not limited to food security, transportation security, and ability to access health care.

  • Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, September 2022 Release
  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.73
Treatment Intervention Preference

Person's goals, preferences, and priorities for care and treatment in case that person is unable to make medical decisions because of a serious illness or injury. Examples include but are not limited to preferences regarding cardiopulmonary resuscitation, endotracheal intubation, and tube feeding.

  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.73
Care Experience Preference

Person's goals, preferences, and priorities for overall experiences during their care and treatment. Examples include but are not limited to honoring religious beliefs, and conditions of the care environment.

  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.73

Comment

HL7 Patient Care Work Group Commendation

HL7 Patient Care Work Group would like to commend ONC for including Treatment Intervention Preference and Care Experience Preferences as data elements in the Goal data class. Providing the ability to specify patient's preferences is integral to improved patient outcomes. Thank you for your foresight. 

Clarification needed for Goals data class

Goals and preferences are not the same type of thing.  A goal is an state you wish to attain.  I preference is a choice about a pathway you would like or not like to take.  Specifically the standards have identified Treatment Preferences and Care Experience Preferences. (See both the CDA PACP Standard and the FHIR ADI Standard).  If ONC wants to keep Goals and Preferences in one data class, the name for the data class should be changed to Goals and Preferences. 

Goals are best reflected through advance directives

The goals section on the latest version seems too vague to me to be of use to clinicians and others accessing a patient's records. Instead, the previous Advance Directive section, that included 6 elements including information on the medical power of attorney and other aspects of a pertson's goals and preferences would be better to include. As a practicing palliative care nurse practitioner, I include a section on the patient's goals in my notes, but this is not the case for the other clinicians in my hospital. Adoption of Advance Directives should be considered in USCDI V2. 

NCPDP Comment

NCPDP supports comments submitted by Pharmacy HIT Collaborative for Outcome Reference and Outcome Code.

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