Emergency Rooms Have Trouble Finding Advance Directives

February 24, 2017

Two new studies show that ER doctors are almost never able to find their patients’ advance directives in Electronic Health Records (EHRs).

Advance directives are your Health Care Power of Attorney and Living Will.  Your Health Care Power of attorney states who will make health care decisions for you when you cannot.  Your Living Will states your preferences for life support at end of life.  

Both studies were reported in the Journal of Palliative Medicine.  The first study looked at ER usage of advance directives.  The study found that 59% of patients had completed an advance directive, but the ER was only able to find it in the EHR 13% of the time.  Even in cases when patients said they previously gave copies to the hospital, the advance directives were still missing 69% of the time.   

The second study surveyed ER doctors about their thoughts on advance directives and EHRs. The results were shocking. Fewer than 1/3 of ER doctors felt “very confident” or “extremely confident” that they could locate the patient’s advance directive in the EHR—when there was one to be found.

A separate survey of ER doctors completed by Geneia in 2015 found that 93% are “less frustrated” when advance directives are “easily accessible.” The vast majority of them said the documents let them “provide a better quality of patient care” and that family members are “more satisfied with the medical care.”

There are several methods to increase the likelihood that your advance directives will be used.  First, you must have advance directives.  Second, inform your loved ones of the location and content of your advance directives.  Your loved ones need to know who is in charge and what decisions you have already made regarding your medical care.  Knowledge can help all of your loved ones work together amicably.   Third, give a copy of your advance directives to the people you have appointed. 

Fourth, consider carrying a copy of your advance directives.  Applications on phones and tablets can store medical information.  Apple’s health app, the iBlueButton app, and the OnPatient app are three widely used applications.  DocuBank provides an emergency card that can be carried in your wallet.  It lists allergies, emergency contacts, and gives directions for the hospital to print a copy of your advance directives or have a copy faxed to them.

Having advance directives is not enough; they must be accessible to be useful.

Karen Baim Reagler is an attorney in Hot Springs and serves clients in Hot Springs, Hot Springs Village, Garland County, Saline County, and western Arkansas.  Ms. Reagler practices estate planning, trusts, wills, estate and trust administration, business administration, business creation, business succession planning, and many other areas of law.

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