While our Care plan is comprehensive, updates that are "typed into text boxes" can be difficult to track and monitor over time.  This requires more work for the care manager each month.  It also becomes difficult for practices to align goals with quality measures. To circumvent this, ThoroughCare has developed a Goals and Barriers section in the care plan to help motivate patients to work towards goals and move past barriers.

Goals and Barriers are managed within the patient’s Care Management tab. To navigate to a patient’s Care Management tab, first travel to a patient’s page. For this example we will be using a patient's CCM page.

On the ThoroughCare Dashboard, search for the target patient that is to be enrolled by selecting the search bar at the top of the page. Users can search by patient First Name, Last Name, or EHR ID number.

On the Patient Search Results screen, select the target patient by clicking their name, EHR ID, or "View" button under the "Actions" column.

From the Patient View Page, select the "Care Management" tab located under the patient information. From here, make sure the proper care management tab is selected.

Once on the target patient’s program page, scroll down the page to view the program management tabs.

Below there will be several tabs below, two of which are labeled “Goals” and “Barriers”. This is where users can view or edit a patient’s goals or barriers. This article will use “Goals” as an example, but the examples will apply to “Barriers” as well.

Once the desired tab is selected, a list of goals/barriers will appear. Select one of the items listed to start interacting with it.

Once selected, the screen will change to show the list of items on the left, shown in red, and a section to the right, shown in blue, that allows the user to interact with the selected problem/goal.

From the image above, the blue section is where users can edit the goal/barrier that was selected from the left. Here users can edit the current status, the date the update happened, add extra notes, view previous notes and, for goals only, select how motivated the patient is to address the goal.

Let’s start with the status. Click on the dropdown labeled “Status”.

Once selected, users will see a list of options they can select. The most important of these are the different options for once the goal/barrier has been met/dealt with. Below the options can be seen. Select the option that applies to the selected goal/barrier.

Note: Once a new status is selected, the “Notes” section will automatically populate, saying that the status of the goal/problem has changed to whichever option was selected.

Next, select the box labeled “Date”. This allows the user to select the date the goal/barrier was updated on.

Once the box is clicked, a calendar will appear. Users should select the appropriate date and time the update happened.

Note: The current date and time will automatically populate this field.

Note: Only the current date or past dates can be selected.

Next, users can add notes to the goals/barriers that supplement the current update. To do this, just type in the text box labeled “Notes”.

Users can also view the previous updates that were made in the “Previous Updates” section. Users can also edit the “Previous Updates” section, but only for updates that they have made themselves.

Only super admin users can change any previous user update, even if they had not created the update originally. To edit a previous update, select the blue button next to “Previous Updates”.

Once selected, edits can be made to the updates as shown below. Once finished, click the blue button to save the changes.

You will then be prompted in your browser to confirm the changes, click the blue “OK” button to confirm.

Only for goals, users can select a number from 1-10 that describes how motivated they patient is to address this goal. If this number is selected, it will be automatically added to the notes of this goal. In the future as well, this number can reset using the gray “Reset” button on the left.

Once finished with the current goal, click the blue “Save” button in the bottom right corner to save the changes made.

Notice that the status update will be changed, for example going from the blue “In Progress” to the green “Closed: Met”.