Conclusions and working assumptions that will guide treatment of the patient, and recommendations for future treatment.

Data Element

Care Plan
Description (*Please confirm or update this field for the new USCDI version*)

Shared plan informed by members of a coordinated care team that details conditions, needs, and goals along with strategies for addressing them.

Usage notes: Includes prioritized problems, health concerns, assessments, goals, and interventions from across care settings.

Examples include nursing care plan, diabetic care plan, multiple chronic conditions care plan, and long term services and support care plan.

Comment

ANI's comment on USCDI v6: Care Plan

The Alliance for Nursing Informatics (ANI) supports the inclusion of this data element and adds our comments below. Please see previously submitted ANI comments for additional recommendations.

  • Consider reframing to a “patient care plan” that is longitudinal, interdisciplinary, and dynamic. 
  • Include patient preferences, values, and goals explicitly, and how this connects to the “patient goals” data element. 
  • Clarify how the care plan is rendered, where it fits in messaging, and how it aligns with FHIR. Certified EHRs and hospitals have a variety of ways to meet the care plan requirements (i.e., discrete, both discrete and text, text only), which should be considered with the ability to transmit this data meaningfully. This is a potential technical challenge, and a challenge in sending meaningful data.

Care plan (record artifact): 734163000

Care plan (record artifact): 734163000

 

Looking at SNOMED CT international edition for care plan (record artifact).

All of the 76 subtype (descendant) concepts (all the types of care plans) are below...

 

 

Children (76)

 

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