Use of an Ambulatory Patient Portal for Advance Care Planning Engagement

Brungardt, Adreanne; Daddato, Andrea E.; Parnes, Bennett; Lum, Hillary D.

doi:10.3122/jabfm.2019.06.190016

Cited by 13 publications

(14 citation statements)

References 22 publications

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“…Creating comprehensive and multidisciplinary care plans Care plans described by the included sources all focused on addressing patients’ goals of care, specifically goals of care nearing end of life. Eight studies incorporated ACP, 28 , 31 , 32 , 34 , 35 , 43 , 44 , 48 with one using an EHR ACP interface to allow for standardized planning. 44 Sources also focused on providing home-based care, featuring home assessments and interdisciplinary care home visits.…”

Section: Resultsmentioning

confidence: 99%

Intersectoral communication amongst healthcare providers regarding care plans: a scoping review

et al. 2022

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Palliative care has become an increasingly important public health issue due to the rising acceptance of implementing a health promoting palliative care approach. To explore communication pathways that would facilitate implementation of this approach, we conducted a scoping review examining communication and enactment of care plans for older adults with life-limiting illnesses across health, social and community sectors. We used a scoping review methodology to map the current literature on communication plans between primary care and other sectors (community, health, and social). Five databases were searched MEDLINE (ovid), CINAHL (EBSCO), EMBASE (Elsevier), PsychInfo (EBSCO), and Scopus. The database search identified 5,289 records, after screening and hand-searching a total of 28 articles were extracted. Three major themes were determined through the records: (1) the importance of professional relationships across sectors, (2) the importance of community navigators in sharing the care plan, and (3) and creating comprehensive and multidisciplinary care plans. Findings suggested that enacting quality care plans is important to healthcare providers; the use of an electronic health records system can be useful in ensuring that all healthcare and community systems are in place to aid patients for better community-based care. Community navigators were also key to ensure that plans are communicated properly and efficiently. Further research is needed to determine how having a clear and properly implemented communication system for a healthcare system could facilitate community sector involvement in implementing care plans.

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Section: Resultsmentioning

confidence: 99%

Intersectoral communication amongst healthcare providers regarding care plans: a scoping review

et al. 2022

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“…We identified two tools (PatientSite and MyChart) that use a guided, patient-centered questionnaire to enable the completion of an advance directive [ 24 , 33 , 34 ]. Although most of the tools allow users to complete and submit an advance directive that directly integrates into the electronic health record [ 22 , 23 , 35 , 36 ], we identified one tool based on My Health Manager (a Kaiser Permanente portal built through Epic software) that links users to an external website to complete the advance directive [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…Table 1 illustrates these findings in detail. Portal use was most often measured by the mean number of log-ins and duration in minutes [ 40 , 41 , 47 ], number of registered users [ 45 ], features accessed [ 38 , 40 , 41 , 47 ], or completed activities such as completing an AD or other ACP-related documentation [ 22 , 24 , 33 - 36 ] or inputting a daily goal [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

Patient Portals to Support Palliative and End-of-Life Care: Scoping Review

Ingle¹,

Valdovinos²,

Ford³

et al. 2021

J Med Internet Res

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Background Although patient portals are widely used for health promotion, little is known about the use of palliative care and end-of-life (PCEOL) portal tools available for patients and caregivers. Objective This study aims to identify and assess the user perspectives of PCEOL portal tools available to patients and caregivers described and evaluated in the literature. Methods We performed a scoping review of the academic literature directed by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) extension for Scoping Review and searched three databases. Sources were included if they reported the development or testing of a feature, resource, tool, or intervention; focused on at least one PCEOL domain defined by the National Coalition for Hospice and Palliative Care; targeted adults with serious illness or caregivers; and were offered via a patient portal tethered to an electronic medical record. We independently screened the titles and abstracts (n=796) for eligibility. Full-text (84/796, 10.6%) sources were reviewed. We abstracted descriptions of the portal tool name, content, targeted population, and reported user acceptability for each tool from included sources (n=19). Results In total, 19 articles describing 12 tools were included, addressing the following PCEOL domains: ethical or legal (n=5), physical (n=5), and psychological or psychiatric (n=2). No tools for bereavement or hospice care were identified. Studies have reported high acceptability of tools among users; however, few sources commented on usability among older adults. Conclusions PCEOL patient portal tools are understudied. As medical care increasingly moves toward virtual platforms, future research should investigate the usability and acceptability of PCEOL patient portal resources and evaluate their impact on health outcomes.

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“…Brungardt et al 11 reported on improving Advance-Care Planning (ACP) outcomes by engaging older adults through portal-based tools, including an electronic Medical Durable Power of Attorney form. Brief motivational messages about ACP via a patient portal were initiated, and if not read within 2 weeks, a mailed postcard reminder was sent.…”

Section: End-of-life Care and Advance-care Planningmentioning

confidence: 99%

New Research on Back Pain, Diet and Diabetes, Advanced Care Planning, and Other Issues Frequently Seen in Family Medicine

Bowman¹,

Neale²,

Seehusen

2019

J Am Board Fam Med

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From the United States and Netherlands, we have 2 articles on back pain, with findings that indicate significant treatment differences between the countries, and a high likelihood of persistence. The Inflammatory Diet is now shown to be related to diabetes. Multiple perspectives on palliative care for the homeless. Could pharmacists assist in preventing suicide? There are changes in the practice of family medicine. Social determinants of health substantially influence health and medical care. Moreover, care for patients from deprived communities is under-reimbursed. Patient pre-existing conditions increased after the Affordable Care Act, suggesting that repealing pre-existing condition protections would likely exacerbate disparities in health and health care. (J Am Board Fam Med 2019;32:759-762.) Interventions and Long-Term Outcomes of Back Pain in Older Patients Early imaging of patients with low back pain is discouraged unless certain "red flags" are present; older age is 1 of the recognized red flags. Powell et al 1 examined the long-term implications of early imaging in more than 57,000 patients in Medicare Advantage Plans. Patients seeing primary care or chiropractors for the initial visit had less imaging and fewer interventions. Imaging was associated with increased narcotic use and surgical intervention. Some of the findings are troubling in light of the ongoing "opioid epidemic." Unfortunately, van der Gaag et al 2 found that back pain in Dutch adults over age 55 years is quite persistent over the next 5 years. Of note, the imaging rate was substantially higher in the United States than in the Netherlands. The use of physical therapy or chiropractic therapy was higher in the Netherlands. Perhaps, we should also think, "Yoga anyone?" Penrod et al 3 found that back pain is one of the most common associations with mentions of yoga in the medical records of a large health system. In addition, over 10 years, the percentage of charts with mention of yoga increased 10-fold.

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Use of an Ambulatory Patient Portal for Advance Care Planning Engagement

Cited by 13 publications

References 22 publications

Intersectoral communication amongst healthcare providers regarding care plans: a scoping review

Intersectoral communication amongst healthcare providers regarding care plans: a scoping review

Patient Portals to Support Palliative and End-of-Life Care: Scoping Review

New Research on Back Pain, Diet and Diabetes, Advanced Care Planning, and Other Issues Frequently Seen in Family Medicine

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