Use of an Ambulatory Patient Portal for Advance Care Planning Engagement
| Autor: | Adreanne Brungardt, Andrea E. Daddato, Hillary D. Lum, Bennett Parnes |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Advance care planning
Male medicine.medical_specialty Quality management 020205 medical informatics Health Services for the Aged Population Pilot Projects 02 engineering and technology Ambulatory Care Facilities Article 03 medical and health sciences Advance Care Planning 0302 clinical medicine Power of attorney stomatognathic system Patient Portals 0202 electrical engineering electronic engineering information engineering medicine Humans 030212 general & internal medicine Patient participation education Aged Aged 80 and over education.field_of_study Academic Medical Centers Electronic Mail business.industry Public Health Environmental and Occupational Health Patient portal Quality Improvement humanities Outreach Family medicine Female Patient Participation Family Practice business End-of-life care |
| Zdroj: | Journal of the American Board of Family Medicine : JABFM. 32(6) |
| ISSN: | 1558-7118 |
| Popis: | Background: Primary care clinics need sustainable, population-based approaches to engage patients in advance care planning (ACP). Patient portal-based ACP tools may provide an option for patient engagement. Objective: To increase ACP outcomes by engaging older adults through portal-based ACP tools, including an electronic Medical Durable Power of Attorney (MDPOA) form. Methods: Geriatric clinic pilot of a multi-modal population-based outreach strategy for portal-based ACP tools. Outreach was to patients (n = 105) who were 65 years and older with an active portal account, no cognitive impairment, and no MDPOA on file. Patients received a motivational message via the portal and, if not read within 2 weeks, a mailed postcard about the portal-based ACP tools. Primary outcome was composite of any ACP action at 1-year including 1) new advance directive (AD) in the electronic health record, 2) use of portal-based ACP tools, or 3) documented ACP discussion with a provider. Results: Sixty-five older adults read the electronic message at 12 months. Seventeen (16%) engaged in at least 1 ACP action. Fourteen of 17 engaged by adding an AD to their record. More patients completed an AD on article or brought a previously completed AD to clinic, compared with choosing to complete an electronic MDPOA via the portal. Conclusions: Brief motivational messages about ACP via a patient portal is feasible and may increase ACP outcomes for older adults in primary care. Future studies should evaluate population-based portal outreach strategies in combination with team-based workflows to enhance patient engagement in ACP. |
| Databáze: | OpenAIRE |
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