Modification of Personalized Health Care Plans Based on Patient Adherence to Patient Actions

摘要

Mechanisms are provided for implementing a personalized patient care plan (PPCP) system. The PPCP system obtains personal and medical information about the patient and generates a patient registry record in a patient registry. The PPCP system generates a PPCP for the patient, comprising a sequence of goals for the patient, based on an analysis of the obtained personal and medical information. Each goal has an associated patient action to be performed by the patient. The PPCP system monitors performance of the goals to determine, for each goal, whether the associated patient action is performed by the patient. In response to determining that the patient did not perform an associated patient action, the PPCP system modifies a goal of the personalized patient care plan to replace the associated patient action with a replacement patient action that is more likely to be performed by the patient.

主权项

1. A method, in a data processing system comprising at least one processor and a memory comprising instructions which, when executed by the at least one processor, cause the at least one processor to implement a personalized patient care plan (PPCP) system, the method comprising:
obtaining, by the PPCP system, personal and medical information about the patient via an initial assessment of the patient; generating, by the PPCP system, a patient registry record in a patient registry based on the obtained personal and medical information; automatically generating, by the PPCP system, a personalized patient care plan for the patient, comprising a sequence of goals for the patient, based on an analysis of the obtained personal and medical information in the patient registry record, wherein each goal has at least one associated patient action to be performed by the patient and at least one monitoring action to be performed by an assessor; monitoring, by the PPCP system, performance of the goals of the personalized patient care plan to determine, for each goal, whether the at least one associated patient action is performed by the patient; and in response to determining that the patient did not perform an associated patient action in the at least one associated patient action, modifying, by the PPCP system, at least one goal of the personalized patient care plan to replace the associated patient action with at least one replacement patient action that is more likely to be performed by the patient.