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Patient Perspectives on Advance Care Planning via a Patient Portal.
Am J Hosp Palliat Care. 2019 Aug; 36(8):682-687.AJ

Abstract

BACKGROUND

Patient portals can offer patients an opportunity to engage in the advance care planning (ACP) process outside of clinical visits.

OBJECTIVE

To describe patient perspectives on use of patient portal-based ACP tools.

DESIGN

Interviews with patients who used portal-based ACP tools. The tools included an electronic Medical Durable Power of Attorney (MDPOA) form to designate a medical decision maker, a patient-centered educational web page, online messaging, and patient access to completed advance directives stored in the electronic health record (EHR).

SETTING

Regional health-care system with a common EHR.

MEASUREMENTS

Semistructured interviews with purposefully sampled patients who used the ACP tools. Questions explored motivations for using the tools and perceptions about how the tools fit into ACP. Analysis followed a grounded hermeneutic editing approach.

RESULTS

From 46 patients (mean age: 49, 63% female), 4 key themes emerged: (1) individualized explorations of the ACP tools, (2) personal initiation and engagement with ACP tools through the portal, (3) value of connecting ACP portal tools to clinical care, and (4) practicality of the ACP tools. Patients described benefits of communicating with health-care team members who referred them to online ACP tools, as well as having the electronic MDPOA form connected to clinical care.

CONCLUSIONS

Patients considered the portal-based ACP tools to be practical and feasible to use within the scope of their own ACP experiences. Further study is needed to understand whether portal-based ACP tools increase the quality and quantity of ACP conversations and documentation that is available to inform medical decision-making.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Jordan SR
1 Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Brungardt A
1 Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Phimphasone-Brady P
2 Department of Family Medicine and Adult and Child Consortium for Health Outcomes and Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, CO, USA.
Lum HD
1 Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA. 3 Rocky Mountain Region VA Geriatric Research Education and Clinical Center, Aurora, CO, USA.

MeSH

AdultAdvance Care PlanningAgedAged, 80 and overElectronic Health RecordsElectronic MailFemaleHumansMaleMiddle AgedPatient Education as TopicPatient PortalsQualitative Research

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30803245

Citation

Jordan, Sarah R., et al. "Patient Perspectives On Advance Care Planning Via a Patient Portal." The American Journal of Hospice & Palliative Care, vol. 36, no. 8, 2019, pp. 682-687.
Jordan SR, Brungardt A, Phimphasone-Brady P, et al. Patient Perspectives on Advance Care Planning via a Patient Portal. Am J Hosp Palliat Care. 2019;36(8):682-687.
Jordan, S. R., Brungardt, A., Phimphasone-Brady, P., & Lum, H. D. (2019). Patient Perspectives on Advance Care Planning via a Patient Portal. The American Journal of Hospice & Palliative Care, 36(8), 682-687. https://doi.org/10.1177/1049909119832820
Jordan SR, et al. Patient Perspectives On Advance Care Planning Via a Patient Portal. Am J Hosp Palliat Care. 2019;36(8):682-687. PubMed PMID: 30803245.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patient Perspectives on Advance Care Planning via a Patient Portal. AU - Jordan,Sarah R, AU - Brungardt,Adreanne, AU - Phimphasone-Brady,Phoutdavone, AU - Lum,Hillary D, Y1 - 2019/02/25/ PY - 2019/2/26/pubmed PY - 2020/1/30/medline PY - 2019/2/27/entrez KW - advance care planning KW - advance directive KW - electronic health record KW - health information technology KW - patient portal KW - qualitative SP - 682 EP - 687 JF - The American journal of hospice & palliative care JO - Am J Hosp Palliat Care VL - 36 IS - 8 N2 - BACKGROUND: Patient portals can offer patients an opportunity to engage in the advance care planning (ACP) process outside of clinical visits. OBJECTIVE: To describe patient perspectives on use of patient portal-based ACP tools. DESIGN: Interviews with patients who used portal-based ACP tools. The tools included an electronic Medical Durable Power of Attorney (MDPOA) form to designate a medical decision maker, a patient-centered educational web page, online messaging, and patient access to completed advance directives stored in the electronic health record (EHR). SETTING: Regional health-care system with a common EHR. MEASUREMENTS: Semistructured interviews with purposefully sampled patients who used the ACP tools. Questions explored motivations for using the tools and perceptions about how the tools fit into ACP. Analysis followed a grounded hermeneutic editing approach. RESULTS: From 46 patients (mean age: 49, 63% female), 4 key themes emerged: (1) individualized explorations of the ACP tools, (2) personal initiation and engagement with ACP tools through the portal, (3) value of connecting ACP portal tools to clinical care, and (4) practicality of the ACP tools. Patients described benefits of communicating with health-care team members who referred them to online ACP tools, as well as having the electronic MDPOA form connected to clinical care. CONCLUSIONS: Patients considered the portal-based ACP tools to be practical and feasible to use within the scope of their own ACP experiences. Further study is needed to understand whether portal-based ACP tools increase the quality and quantity of ACP conversations and documentation that is available to inform medical decision-making. SN - 1938-2715 UR - https://www.unboundmedicine.com/medline/citation/30803245/Patient_Perspectives_on_Advance_Care_Planning_via_a_Patient_Portal_ DB - PRIME DP - Unbound Medicine ER -