Does ePOLST Have an Impact During COVID-19? So Far, the Answer Is Yes.

As the country continues to fight this pandemic, we thought it would be valuable to look back over the past few months to see how healthcare organizations are leveraging Vynca’s advance care planning solutions. In addition to the focus on slowing down the spread of the disease, there is a parallel focus on clarifying and documenting goals of care for people of all ages. The data suggests it’s best to do this digitally.

A lookback over the past several months has brought to light some interesting trends. When looking at healthcare partner data, we focused on:

1. Electronic completion of POLST (ePOLST)
2. Electronic documents initiated by a Preparer
3. Hospital admissions for patients with a scanned POLST vs ePOLST
4. Other notable trends

ePOLST Completion

First, let’s clarify ePOLST. Healthcare organizations that leverage Vynca have the capability to complete POLST forms (and other documents) electronically. Clinicians can electronically select choices that reflect the conversation they are having with their patient. Electronic completion prevents clinicians from selecting discordant choices, includes pop-up reminders, education and guides, date stamps all documents, and ensures all required signatures are captured using our proprietary eSignature technology. The result is a 100% digital, legally valid, actionable document, that is available across all care settings. Knowing that there may be previously completed paper POLST forms (and other documents), these existing documents can be scanned into Vynca, and available on the clinician ACP dashboard.

We went back and looked at ePOLST completion rates from February – May. During this time period, we saw an increase in ePOLST completion rates as many providers transitioned to telehealth visits and were able to complete the POLST forms through Vynca’s eSignature technology.

Electronic Documents Initiated by a Preparer

Within Vynca, each user is assigned a role. One of these roles is a Preparer. A Preparer is a clinician or facilitator who engages in advance care planning conversations with the patient and can start the document completion process, but cannot sign the POLST form. Preparers usually include roles such as nurses, social workers, care managers, etc. Preparers were able to quickly pivot and leverage our solution via telehealth, allowing them to engage in conversations, start a document, and bill the ACP CPT codes 99497 and 99498.

Over this time period, we saw more advance care planning documents in our system being initiated by Preparers.

Hospitalizations for Patients with a Scanned POLST vs ePOLST

We wanted to see if there was an impact on healthcare utilization when a POLST form was scanned into Vynca vs. created digitally within our solution. In order to better understand this, we looked at:

1. ED patient visits, February – May
2. Patients that had a POLST on record in Vynca
3. Clinician accesses within the ED
4. Admission rate for patients that had an ePOLST vs scanned POLST in Vynca

Our analysis found a 41% reduction in hospital admissions when an ePOLST was viewed in the ED vs when a scanned POLST was viewed.

Other Trends

It’s interesting to note some other trends we observed with our healthcare partners during this time, some of which may be expected:

• A rising number of advance directives being completed, both clinician and patient initiated
• An increased rate of clinician views into Vynca through our EHR-integrated solution and web portal
• An increase in training for both operational and clinical guidance on patient encounter ACP workflows

What Conclusions Can We Draw?

While we may not know all the contributing factors, it’s safe to say advance care planning is having its moment. We see this in the news, as well as in our data.

What we can conclude:

• Vynca’s digital capabilities are needed now more than ever during this time, as we see this shift to telehealth
• Our healthcare partners are doing active outreach to their high-risk populations to initiate advance care planning conversations, and an increasing number of patients are reaching out to providers to engage in these conversations
• Healthcare partners are leveraging our solution for telehealth consults, and billing against CPT codes – this is supported by the increase in ePOLST completion rates
• A broader range of clinicians are engaging in the advance care planning process, and initiating these conversations – supported by the increase in preparer initiated documents
• Digitally completed documents are of higher quality than those completed on paper, and have a greater impact on patient care

While it is impossible to predict the future, it seems likely COVID-19 will be with us for quite some time.  And with so many negative things happening because of COVID-19, advance care planning is not one of those negatives. In fact, it’s thriving and making a true impact on patient care. Our healthcare partners are proof of that.

You can view the full case study here.

Michael Kersten is the Director of Partner Solutions.