Moving Advance Care Planning into the Digital World

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Nurse giving glass of water to elderly woman in wheelchair at retirement home. Assisting senior people

By Brian Yeaman, M.D., and Michael Munoz

Many consumers and healthcare providers have long believed that Advance Care Planning (ACP) was reserved only for the elderly or the extremely sick or frail. The COVID-19 pandemic has proved otherwise. It’s a blunt reminder that all patients want to be sure they have a way to speak for themselves in case no one is there to tell their medical team of their wishes.The pandemic has also brought to light the startling reality that even those who have committed their wishes to paper sometimes discover these documents are nowhere to be found, or they are difficult to access in the patchwork of electronic health record (EHR) platforms. And records that can’t be found are meaningless.

While healthcare professionals often understand the need for such planning and the value it brings, many lack the time required to search for advance directives when they’re overworked and unduly stressed. Emergency care providers especially feel the pain of receiving patients without ACP documents. They’re committed to providing the best possible care that aligns with patient values and priorities but struggle when they can’t communicate with those in their care.

Without the ability to quickly locate and retrieve ACP documents and portable medical orders when needed, healthcare providers will continue to experience lost productivity and higher emotional stress levels.  They may also unintentionally put the patient at risk of experiencing mistakes or misguided care, including unwanted or unnecessary hospitalizations and medical interventions.

Clearly it is time to squarely address this deficiency in our healthcare ecosystem by moving ACP into the digital world. Technology helps patients create, modify, upload, and share ACP documents and portable medical orders into a secure, interoperable registry. Those documents can then be made securely and seamlessly available in electronic health record platforms across the continuum of care, 24 hours a day, 7 days a week, and every day of the year. Ensuring the patient’s voice in clinical decision-making is heard has been shown to both improve healthcare outcomes and reduce healthcare costs. Nonetheless, some hospitals still hesitate to implement digital ACP because they:

  • worry digital ACP solutions won’t seamlessly or securely integrate with their existing EHR.
  • believe that implementation of the solutions and modification of their clinical workflows will be cumbersome or too complicated.
  • are concerned digital ACP solutions vendors will charge prices comparable to those of a complete EHR platform, and they don’t want to invest the time and money on services they won’t use.

Fortunately, today revolutionary tools are available that successfully address these concerns and allow for the effective implementation of digital ACP. But not all instruments are the same.In looking for such tools, healthcare providers should seek a partner who has invested heavily in making ACP document upload, as well as document query and retrieval, a simple process, so organizations can perform these activities without having to initiate an expansive integration.

They should seek one whose platforms can stand up to rigorous security, interoperability, usability, and quality reviews. And they should seek one built in a modular structure that allows them to select and pay for only those features most relevant to their needs so they don’t overpay to access digital ACP documents and portable medical orders.

When hospitals choose wisely to invest in digital ACP, everyone benefits.  That’s because effective digital ACP has been shown to:

  • positively impact medical team morale and reduce clinical burnout by alleviating everyday frustrations.
  • decrease healthcare costs by avoiding unwanted and unnecessary hospitalizations, medical treatments, and interventions and supporting patient-centered, clinical excellence. 
  • boost quality metrics and performance scores.
  • remove family and provider anxiety about honoring patient wishes in an emergency when they can’t speak for themselves.
  • provide patients peace of mind by increasing the likelihood that their voices will be heard.

    In the final analysis, digital ACP is a smart and prudent way to avoid high-cost, low-value care, honor patient wishes, and position your organization as a preferred healthcare provider. And that makes its implementation simply too important to delay.

Brian Yeaman, M.D., is medical director and Michael Munoz is chief product officer at ADVault, Inc., the nation’s leader in digital advance care planning solutions.  It’s end-to-end, cloud-based, SaaS solutions empower healthcare providers to help patients document and store their healthcare wishes in a secure, electronic registry and repository that can be accessed by medical teams anytime, anywhere. http://www.advaultinc.com/