The Year of Patient Engagement. Technology Can Play a Role in Engaging Patients in Advance Care Planning

Advance care planning refers to a lifelong process that enables patients to make important decisions regarding their future health care, in the event they are no longer capable of communicating their preferences. Through open discussion with their loved ones and health care providers, advance care planning allows patients to express their values, beliefs, and wishes for their end of life care. Once documented, these conversations provide patients autonomy over how they want to live their lives, when they need it the most. This is why it is important to engage the patient and their family members early, but the reality is only one in three US adults have completed an advance directive. With the public demanding accountability for their wishes, and hospital systems aiming to prioritize quality based care efforts, encouraging ACP conversations and proper documentation are growing in importance.

In 2016, Medicare issued two codes (CPT 99497, 99498) to encourage advance care planning discussions, and provide reimbursement for these discussions. In the first year, 22,000 providers billed for advance care planning on behalf of 570,000+ beneficiaries. This resulted in more than $43 million dollars in Medicare reimbursement.

Patient engagement is one of the top trends expected to dominate healthcare in 2019, and healthcare organizations are expected to invest in technology to reach patients in their home setting. It makes sense to start, and encourage, ongoing advance care planning conversations outside of the clinical setting. One way to do this is through existing patient engagement tools, such as a patient portal. Providing secure, 24 hour access, a patient can be educated on advance care planning, complete documentation, such as an advance directive, and contact a clinician when convenient. This documentation will then be available to providers in real time to guide future conversations and treatments.

Advance care planning is beneficial to all parties involved, and engaging patients outside of the clinical setting will (hopefully) increase the number of US adults completing documents. It will improve the quality of care patients receive, by empowering them to make decisions on treatments for their end of life care. For families and loved ones, it can ease the burden of a very difficult situation. For providers, advance care planning can help them reach organizational success by increasing patient satisfaction, decreasing cost, unwanted utilization, and ultimately, putting patients at the center of their care – as it should be.