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 illustrate major categories of preferences in order to test usability and completeness of the model.
- 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
- e.g. Disallow blood transfusion
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
Other Personal Preference
- Patient satisfaction
- Diet preferences (vegetarian)
- Affordability of care
- for this example there may be a Care Barrier as well used to track, managed and support finding assistance for the patient
- e.g. Patient asks that care givers always speak with the daughter
- Eliminate frustration so daughter does not have to repeat every time
- Bad relationship with son so avoid this communication
- e.g. Patient specifies preferred email and phone
- The preference code may be a natural code (e.g. simple string) in the absence of a defined vocabulary.
- Vocabulary for preferences needs to be defined
- Model does not include common information management attributes (e.g. preference record create time, update time). It only includes descriptive attributes of the domain.
- A proactive use of preferences defined by the patient or patient's caretaker is linked directly to the "Plan"
- A reactive preference determined as a reaction to proposed plan interventions is directly linked to the Health Activity or Intervention.
|--------- carePreferences [0..*] --|
|--------------- interventions[0..*] --|
Class Instances for validation