Skip to main content

Main menu

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • Other Publications
    • abfm

User menu

Search

  • Advanced search
American Board of Family Medicine
  • Other Publications
    • abfm
American Board of Family Medicine

American Board of Family Medicine

Advanced Search

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • JABFM on Bluesky
  • JABFM On Facebook
  • JABFM On Twitter
  • JABFM On YouTube

Deployment of a Digital Advance Care Planning Platform at an Accountable Care Organization in the United States: A Retrospective Analysis

ORIGINAL RESEARCH

R. Lynae Roberts; Desh P. Mohan; Katelin D. Cherry; Samantha Sanky; Taylor R. Huffman; Christina Lukasko; Anthony Comito; Dara Hashemi; Zachary K. Menn; Tatiana Y. Fofanova; Julia D. Andrieni

Corresponding Author: R. Lynae Roberts, PhD; Koda Health

Email: rlroberts918@gmail.com

DOI: 10.3122/jabfm.2023.230133R2

Keywords: Accountable Care Organization, Advance Care Planning, Aging, Health Equity, Retrospective Studies

Dates: Submitted: 04-04-2023; Revised: 06-26-2023; 07-06-2023; Accepted: 07-18-2023

AHEAD OF PRINT: |HTML| |PDF|  FINAL PUBLICATION: |HTML| |PDF|


BACKGROUND: Advance care planning (ACP), a process of sharing one’s values and preferences for future medical treatments, can improve quality of life, reduce loved ones’ anxiety, and decrease unwanted medical utilization and costs. Despite benefits to patients and healthcare systems, ACP uptake often remains low, due partially to lack of knowledge and difficulty initiating discussions. Digital tools may help reduce these barriers to entry.

METHODS: We retrospectively examined data from pilot deployment of Koda Health patient-facing ACP among Houston Methodist Coordinated Care patients, for quality improvement (QI) purposes. Patients referred by nurse navigators could access Koda’s digital platform, complete ACP, and share the legal documentation generated. Analyzed measures include usage rates and ACP-related decisions within the platform.

RESULTS: Of eligible patients (n=203), 52.7% voluntarily completed their plan. Engagement and completion rates were similar across demographics. Patients indicated majority preference (66.4%) toward spending the last days of life at home. Most patients indicated wanting no life-support intervention if quality of life became unacceptable (51-71% across four treatments). Life-support decisions were similar between demographic categories, excepting CPR and dialysis, wherein a greater portion of Black patients than White patients preferred at least trial intervention, rather than none.

CONCLUSIONS: As an observational QI analysis, limitations include bounded geographical reach and lack of data on ACP impacts to subsequent healthcare utilization, which future studies will address. Findings suggest that digital health tools like Koda can effectively facilitate equitable ACP access and may help support health systems and providers in offering comprehensive ACP.

ABSTRACTS IN PRESS

Navigate

  • Home
  • Current Issue
  • Past Issues

Authors & Reviewers

  • Info For Authors
  • Info For Reviewers
  • Submit A Manuscript/Review

Other Services

  • Get Email Alerts
  • Classifieds
  • Reprints and Permissions

Other Resources

  • Forms
  • Contact Us
  • ABFM News

© 2025 American Board of Family Medicine

Powered by HighWire