Format

Send to

Choose Destination
J Palliat Med. 2018 Apr;21(4):522-528. doi: 10.1089/jpm.2017.0451. Epub 2018 Jan 23.

Advance Care Planning Documentation in Electronic Health Records: Current Challenges and Recommendations for Change.

Author information

1
1 Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital , Boston, Massachusetts.
2
2 Ariadne Labs , a Joint Center between Brigham and Women's Hospital, Boston, Massachusetts.
3
3 Emeritus Medical Staff, Gundersen Lutheran Medical Center , La Crosse, Wisconsin.
4
4 Palliative Care Programs, Division of Geriatric Medicine, University of North Carolina School of Medicine , Chapel Hill, North Carolina.
5
5 Hertzberg Palliative Care Institute of the Brookdale Department of Geriatrics , Icahn School of Medicine at Mount Sinai, New York, New York.
6
6 Presbyterian Healthcare Services , Albuquerque, New Mexico .
7
7 Chief Program Officer for Patient Care, Gordon and Betty Moore Foundation , Palo Alto, California.
8
8 Epic Systems Corp. , Verona, Wisconsin.
9
9 Cerner Corp. , Kansas City, Missouri.
10
10 Division of Psychosocial Oncology, Dana-Farber Cancer Institute , Boston, Massachusetts.

Abstract

OBJECTIVE:

To develop a set of clinically relevant recommendations to improve the state of advance care planning (ACP) documentation in the electronic health record (EHR).

BACKGROUND:

Advance care planning (ACP) is a key process that supports goal-concordant care. For preferences to be honored, clinicians must be able to reliably record, find, and use ACP documentation. However, there are no standards to guide ACP documentation in the electronic health record (EHR).

METHODS:

We interviewed 21 key informants to understand the strengths and weaknesses of EHR documentation systems for ACP and identify best practices. We analyzed these interviews using a qualitative content analysis approach and subsequently developed a preliminary set of recommendations. These recommendations were vetted and refined in a second round of input from a national panel of content experts.

RESULTS:

Informants identified six themes regarding current inadequacies in documentation and accessibility of ACP information and opportunities for improvement.

DISCUSSION:

We offer a set of concise, clinically relevant recommendations, informed by expert opinion, to improve the state of ACP documentation in the EHR.

KEYWORDS:

advance care planning; electronic health records; palliative care

PMID:
29360417
DOI:
10.1089/jpm.2017.0451

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center