The GUI design for the IHS RPMS self management component

1. Patient Self-Management
Goal-Setting component and data elements
of the RPMS and RPMS-EHR

2. DOCUMENTING A GOAL NOT SET OR NOT INTERESTED
IN SETTING A GOAL TODAY
Patient Goals
Goal Setting: Goal Set Goal Not Set
Comment: Not interested in setting a goal today
This is the default text, but
can be edited by the clinician
Add Education Add Health Factor Save Goal Edit Goal Cancel

3. DOCUMENTING A LONG-TERM GOAL
Patient Goals
Goal Setting: Goal Set Goal Not Set
Goal: Quit smoking cigarettes Goal #: 3
Type(s) of Goal: Physical Activity Tobacco
Nutrition Alcohol or Drugs
Medicines Stress and Coping
Wellness or Safety (HPDP) Monitoring
Other
These categories are only
documented to enable reporting on
the types of goals that are being
documented. This part of the
component is clinician oriented,
while the rest is patient-centered
Add Education Add Health Factor Save Goal Edit Goal Cancel

4. DOCUMENTING THE START AND FOLLOW UP
Patient Goals
Goal Setting: Goal Set Goal Not Set
Goal: Quit smoking cigarettes Goal #:3
Type of Goal: Tobacco
Reason is used when more advanced goal setting
practices take place such as motivational interviewing
Reason for goal:
Goal Start Date 02/14/2008 Goal Follow-up Date 02/21/2008
Follow up date is used for alerts or iCare displays -
Add Step primarily for patient follow up and care
Goal Complete: Met Changed Maintained
Add Education Add Health Factor Save Goal Edit Goal Cancel

5. ADDING A GOAL STEP
Patient Goals
Goal Setting: Goal Set Goal Not Set
Goal: Quit smoking cigarettes G Goal #: 3
Type of Goal: Tobacco
This would be a step associated with
Motivation goal #3 and would be labeled as 3.1
Goal Start Date 02/14/2008 Goal Follow-up Date 02/21/2008
Step Talk to doctor about getting an Rx for Zyban
Add Step 01/18/2008
Step Start Date
Goal Complete: Goal Met Renegotiated Maintained
Step Follow-up Date 02/14/2008
Add Education Add Health Factor Step Complete:
Save Goal Met Edit Goal
Changed Maintained
Cancel
Save Cancel

6. COMPLETING THE GOAL
Patient Goals
Goal Setting: Goal Set Goal Not Set
Goal: Quit smoking cigarettes Goal #:3
Type of Goal: Tobacco Goals that are not completed are considered active
Met closes out the goal (it then becomes inactive)
Reason for goal:
Changed closes out the goal - you change a goal when
the patient decides to no longer pursue it or when you
Goal Start Date 02/14/2008 Goal Follow-up Date
are reducing the expectations 02/21/2008
Maintained keeps the goal as active but signifies that
the patient achieved it
Add Step
Goal Complete: Met Changed Maintained
Add Education Add Health Factor Save Goal Edit Goal Cancel

7. Last Start Follow
Goal # Goal Set Reason Type of Goal Goal Status Provider
Update Date Up Date
Other:
11/05/08 1 Lose 25 pounds by summer 11/05/08 Personal 6/1/09 Active
health
Buy only 1 bag of low fat
12/31/08 1.3 12/31/08 Nutrition 2/11/09 Active
potato chips a week
Walk 4 times a week by
12/14/08 1.4 12/31/08 Exercise 2/11/09 Active
February appointment
12/31/08 1.1 Walk 3 times a week 12/14/08 Exercise 12/31/08 Step Met
Step
12/31/08 1.2 Stop eating potato chips 12/14/08 Nutrition 12/31/08
Renegotiated
Check blood sugar every day Want to be healthy
12/14/08 2 12/14/08 Monitoring 1/4/09 Maintained
after I get to work for my children
Quit smoking cigarettes in 2
12/31/08 3 2/14/09 Tobacco 2/21/09 Active
weeks
Talk to doctor about getting a
12/31/08 3.1 1/18/09 Tobacco 2/14/09 Active
prescription for Zyban
Active
Last Goals Not Set Provider
Update
2/14/08 Would like to spend more time with friends but has too many job demands.
Does not want to proceed
11/05/08 Not interested in setting a goal at this time
Add Education Add Health Factor Add Goal Edit Goal Delete Goal