Electronic Records and End-of-Life Plans

In a perfect world, patients with advance directives would be confident that their doctors and nurses — no matter where they receive care — could know in a split second their end-of-life wishes. But this ideal is still in the distance. Patients’ documents often go missing in maze-like files or are rendered unreadable by incompatible software. And this risk continues even as health systems and physician practices adopt new electronic health records. So advocates and policymakers are pushing for a fix. The problem isn’t new, experts noted. Advance directives were lost during the era of paper records, too. But, so far, digital efforts have fallen short.

End-of-life planning has been encouraged by ethicists and experts in recent years, who say it communicates patient choices about medical interventions like being connected to a ventilator or feeding tube, or being resuscitated after heart failure — especially when patients can’t speak for themselves. This January, Medicare began paying doctors to discuss end-of-life wishes with patients, a policy almost 90 percent of Americans support. Meanwhile, according to 2015 figures from the Kaiser Family Foundation, 60 percent of adults older than 65 have such directives. Difficulties can arise if, for example, a patient’s doctor uses one record system and the emergency room another. If the software doesn’t match up, the ER doctors may be unable to tell if the patient has a preference like a “do-not-resuscitate” order.
    
Source/more: USA Today/KHN

David Wingate is an elder law attorney at the Elder Law Office of David Wingate, LLC. The elder law office services clients with powers of attorneys, living wills, Wills, Trusts, Medicaid and asset protection. The Elder Law office has locations in Frederick and Montgomery Counties, Maryland.

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