Care Preference

A care preference is a statement expressed by the patient, custodian or caretaker responsible for the patient in order to influence how their care is delivered.

A preference expresses a personal choice and may be driven by cultural, religious and moral principles. As such it is a principal component of patient centered care and autonomy. Care preferences serve as modifiers of the Care Plan which influence how the plan is personalized for the individual.

A care preference may be specified prospectively to influence future care planning and treatment or it may be expressed and recorded at arbitrary decision points during interventions.

A preference expresses a request to fulfill a patient's choice or desire. The choice may be a strong and absolute statement such as an end of life directive. The request could also be a desire to be fulfilled if possible given care team capabilities and resources.

The following examples illustrates major categories of preferences in order to test usability and completeness of the model.

• Treatment preferences
  • e.g. Choice to use certain medications
    • e.g. patient refuses based on his or her risk assessment of side effects
    • e.g. patient requests lower dose due to how they feel after taking a medication cocktail
  • e.g. Choice of surgical procedures
    • e.g. patient does not want invasive procedures performed
  • e.g. Oncology therapy
    • e.g. an informed patient selects a given therapy based on a list of considered alternatives

• End of life preferences
  • Patient does not want to live in a vegetative state
    • e.g. No respirators should be applied
    • e.g. Patient rejects tube feeding
    • e.g. No resuscitation should be applied

• Cultural and religious preferences
  • e.g. Kosher or halal food only
  • e.g. Disallow blood transfusion
  • e.g. Vegetarian diet

• Personal taste preferences
  • Patient satisfaction
  • Diet preferences (vegetarian)
  • Personal reason
    • Affordability of care (for this there may be an associated Care Barrier which could potentially be addressed by a care manager finding programs for which the patient is qualified)

• Communication preferences
  • e.g. Always talk with the daughter
    • Eliminate frustration so daughter does not have to repeat every time
    • Bad relationship with son so avoid this communication
  • e.g. Preferred email and phone

Class:

Care Preference

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preference : Code
effectiveDate : DateTime
expressedBy : Role
strength : Level
comment : Note
media: URL[0..*]
activationCriteria: Criterion[0..*]