Digital efforts are falling short when it comes to advance directives for patients, but changes are slowly being seen in the industry when it comes to communication of this vital information.
Documents can often go missing when they are kept in physical form, according to a report from USA Today, but electronic health records systems have not made the process any smoother.
One of the biggest issues, the report notes, is a lack of interoperability of record systems. If a provider uses a different EHR than an emergency room, an order like "do-not-resuscitate" may not transfer over.
In addition, older patients often bounce from one specialist to another, increasing the chance that systems don't connect, Irene Hamrick, M.D., who directs geriatric services in family medicine at the University of Wisconsin-Madison, tells USA Today.
Meaningful Use requires providers to record in EHRs whether patients 65 and older have an advanced directive. However, that's not overly helpful because it doesn't capture what the patient's actual preferences are, and doesn't require that the information be conveyed to other providers, Eva Powell, director of health IT programs for the National Partnership for Women and Families, told FierceEMR in November 2012.
However, developers, providers and even lawmakers are vying for better functionality, USA Today finds.
EHR vendor Epic has added a tab to indicate if there is an advance directive on file, and Cerner's vice president of interoperability Bob Robke says in the article that advance care planning "is an important issue we're tackling."
In addition, lawmakers are looking at legislation that would require directives be easily accessible across EHRs; and providers, such as Oregon Health & Science University, are making revisions to in-house software to make directives easy to find.
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