Advance Directives: The Patient’s Voice

Participating Organizations: ADVault, Inc., Cerner, HealthFlow, Red Hat, Trisotech

Patients rightly expect that care will be aligned to their personal values and wishes, yet far too often their voice isn’t heard or understood completely. Over the past two years, this disparity has become significant as many patients have come to the emergency room alone and unresponsive, only to receive undesired critical care. A patient’s advance directive or advance care plan can provide valuable information needed to guide the care team in their activities; however, only 37% of the US population have either, and the availability and detail vary dramatically. This leaves medical practitioners relying on a combination of family input (if available) and their best clinical judgment to deliver the best care possible. Given these information gaps, even the best-intentioned clinical actions may lead to unwanted care and even patient harm (“wrongful life”). In this demonstration, participants highlight the use of standards-based interoperable technology and intelligent process automation within an Emergency Department setting. Providing the patient’s healthcare wishes in context and enabling the delivery of goal-aligned care for all patients anytime and anywhere. This patient-centric, state of the art interoperable solution focuses on the orchestration of a patient’s advance directives through the implementation of data (HL7® FHIR®), knowledge (CDS Hooks/CQL), and process (BPM+ Health) standards to: (1)empower preauthorization and other burden reduction tools to deconflict clinical workflows while ensuring the patient’s wishes are met; (2) leverage data automation to remedy the crippling Health IT inefficiencies cluttering clinical workflows; (3) increase velocity and decrease burden across the full cycle of clinical interoperability.