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Brief ReportBrief Report

Use of an Ambulatory Patient Portal for Advance Care Planning Engagement

Adreanne Brungardt, Andrea E. Daddato, Bennett Parnes and Hillary D. Lum
The Journal of the American Board of Family Medicine November 2019, 32 (6) 925-930; DOI: https://doi.org/10.3122/jabfm.2019.06.190016
Adreanne Brungardt
From the Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO (AB, AED, BP, HDL); VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO (HDL).
MM, MT-BC
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Andrea E. Daddato
From the Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO (AB, AED, BP, HDL); VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO (HDL).
MS
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Bennett Parnes
From the Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO (AB, AED, BP, HDL); VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO (HDL).
MD
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Hillary D. Lum
From the Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO (AB, AED, BP, HDL); VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO (HDL).
MD, PhD
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    Figure 1.

    Identification of Outreach Recipients. Electronic health record (EHR) report to identify English-speaking patients with a patient portal account. Two hundred patients were reviewed for eligibility as follows: (A) excluded for lack of Medical Durable Power of Attorney (MDPOA) document in EHR, and (B) excluded for cognitive impairment. *Thirteen patients had both an MDPOA and cognitive impairment. Eligible patients were sent portal outreach message. If portal message was unread at 14 days, patients were mailed an outreach postcard. Advance care planning (ACP) outcomes were collected at 1 year.

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    Table 1.

    Characteristics of Primary Care Patients Who Received an Advance Care Planning Portal-Based Outreach Initiative (n = 105)

    CharacteristicN (%)
    Age, Mean ± SD77.7 ± 5.9
    Female67 (64)
    Patient registry
        Cancer41 (39)
        Diabetes18 (17)
        Chronic kidney disease15 (14)
        Congestive heart failure4 (3.8)
        Chronic obstructive pulmonary disease12 (11)
    Value-based payment program
        Comprehensive Primary Care Plus47 (45)
        Medicare Shared Savings Program46 (44)
    Advance care planning documentation at baseline
        Living will7 (6.7)
        MOST form13 (12)
        No ACP documents, but has provider documentation of orally appointed decision maker61 (58)
    • ACP, advance care planning; MOST, Medical Orders for Scope of Treatment; SD, standard deviation.

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The Journal of the American Board of Family     Medicine: 32 (6)
The Journal of the American Board of Family Medicine
Vol. 32, Issue 6
November-December 2019
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Use of an Ambulatory Patient Portal for Advance Care Planning Engagement
Adreanne Brungardt, Andrea E. Daddato, Bennett Parnes, Hillary D. Lum
The Journal of the American Board of Family Medicine Nov 2019, 32 (6) 925-930; DOI: 10.3122/jabfm.2019.06.190016

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Use of an Ambulatory Patient Portal for Advance Care Planning Engagement
Adreanne Brungardt, Andrea E. Daddato, Bennett Parnes, Hillary D. Lum
The Journal of the American Board of Family Medicine Nov 2019, 32 (6) 925-930; DOI: 10.3122/jabfm.2019.06.190016
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