What is the state blueprint for normalizing advance care planning?
Many believe care for individuals with serious illness facing end of life needs to improve. But how? One of the Aspen Institute Health Strategy Group’s 2017 recommendations calls for normalizing advance care planning (ACP) into our daily lives. Doing so takes a community effort.
A February 2019, Advance Care Planning: Selected States’ Efforts to Educate and Address Access Challenges report by the Government Accountability Office (GAO) found 37 states did not have paper or electronic registries for advance directives or physician orders for life sustaining treatment (POLST) forms.
But more importantly, 14 states were taking the lead by forming state registries to house ACP documents and portable medical order (PMO) forms such as POLST. In designing their programs, these innovators address three challenges on how to:
- Educate citizens on the value of advance care planning discussions.
- Equip individuals and healthcare providers with tools to document medical goals, treatment priorities, and care preferences.
- Make ACP documents and PMO forms accessible to loved ones and medical teams when needed.
To move beyond the registry and into the community one entity recently launched a “Make MyDirectives Your Directives™” initiative powered by ADVault, Inc. It equips residents and healthcare providers with the tools and resources required to overcome historical obstacles to advance care planning (ACP) and ensure everyone has access to the patient’s voice in an emergency.
According to the program sponsors, “The benefits of accessing MyDirectives for Clinicians are plentiful, including an user-friendly platform integrated in the HIE and the ability to create, upload and view new digital advance care planning forms, as required, across all patient care teams with access to the HIE. The forms include National POLST, Psychiatric Advance Directive, and Universal Advance Digital Directive (uADD).”
This initiative supplies 1,300 healthcare providers with FREE MyDirectives for Clinicians™ licenses to facilitate advance care planning with their patients or send patients an invitation to complete the ACP process on their own schedule with the award-winning MyDirectives.com application.
Historically, few clinicians offer to discuss a patient’s medical goals, treatment priorities, and care preferences, much less document those decisions. A problem that is especially prevalent in underserved and marginalized communities. The “Make My Directives Your Directives™” initiative empowers citizens and their healthcare providers with simple to use and even easier to facilitate tools to complete advance care planning, at no cost.
Early on, these stakeholders recognized only a small number of residents had completed the advance care planning process and stored their documents in the HIE, which meant their community lacked a voice in their care. So, they made a collaborative commitment to change that by making a multi-year investment in the digital tools and training resources their citizens need.
“Since 2014, the ADVault Exchange™ registry and repository has been supporting states with a highly secure, interoperable database for uploading, storing, and accessing ACP documents and portable medical orders 24/7 by all fire and EMS responders, hospitals, and hundreds of providers across the country,” said ADVault CEO Scott Brown. “So, we’re extremely excited to extend our collaboration to help residents digitally create a personal advance care plan that captures not only their healthcare preferences regarding CPR, life-sustaining treatment, and artificial nutrition, but also name a healthcare agent and express what’s important to them to achieve a good quality of life, as well as any religious and spiritual priorities. It’s great to see these innovators taking the lead in drafting a blueprint for other states to increase advance care planning in their community.”
Through this new strategic alliance, stakeholders believe they will be able to increase ACP completion in the state and give everyone peace of mind a patient’s values can be considered in an emergency when they are unable to speak for themselves.