Design and Implementation of Patient Portal-Based Advance Care Planning Tools

J Pain Symptom Manage. 2019 Jan;57(1):112-117.e2. doi: 10.1016/j.jpainsymman.2018.10.500. Epub 2018 Oct 25.

Abstract

Background: Electronic health record-based portal tools may help patients engage in advance care planning (ACP). We designed and implemented portal-based ACP tools to enable patients to create a medical durable power of attorney (MDPOA).

Measures: MDPOA documentation and System Usability Scale were assessed.

Intervention: Stakeholder-informed portal-based ACP tools include an electronic MDPOA form, patient educational webpage, online messaging, and patient access to completed advance directives.

Outcomes: A total of 2814 patients used the tools over 15 months. Patients had a mean age 45 years (17-98 years) and 69% were women. Eighty-nine percent completed an MDPOA form, 2% called or sent online messages, and 8% viewed the MDPOA form but did not complete it. The tools were rated highly usable.

Conclusions/lessons learned: Patients demonstrated willingness to use the portal to complete an MDPOA and rated the new ACP tools as highly usable. Future work will optimize population-based outreach strategies to engage patients in ACP through the portal.

Keywords: Advance care planning; advance directive; electronic health record; health information technology; patient portal; surrogate decision maker.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Advance Care Planning*
  • Aged
  • Aged, 80 and over
  • Electronic Health Records*
  • Female
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care
  • Patient Education as Topic
  • Patient Portals*
  • Quality Improvement
  • Software Design
  • Young Adult