The purpose of this research is to examine the feasibility of using a patient portal based advance care planning (ACP) tool to improve ACP discussions and documentation in persons living with cognitive impairment in outpatient primary care.
The goal of this study is to explore whether sending a portal-based ACP tool (called ACPVoice) paired with a motivational message within the patient portal before a routine primary care physician visit can improve ACP discussions and documentation within the electronic health record among persons living with cognitive impairment in outpatient primary care.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
300
Eligible patients will be sent a secure MyChart message with a motivational message asking them to complete the advance care planning tool (ACPVoice) with their care partner/surrogate decision-maker or loved one before their upcoming primary care visit. The ACPVoice tool will be attached electronically to the mychart message. A reminder message will be sent to an non-responders with a different motivational message.
Patients will have access to the standardized advance care planning questionnaires readily available already within their mychart account which is part of standard of care.
Wake Forest University Health Sciences
Winston-Salem, North Carolina, United States
Engagement Rate
Percentage of participants who open the advance care planning tool (ACPVoice) mychart message
Time frame: Up to month 6
Percentage of Intervention Completion
In the ACPVoice arm, completion was defined as completion of the ACPVoice questionnaire following outreach through the patient portal and follow-up reminders. In the Standard of Care arm, completion was defined as completion of the standard Epic ACP questionnaire (ACP For My Care Team Questionnaire) available through the patient portal without additional prompting or outreach.
Time frame: Up to month 6
Advance Care Planning Documentation Rates by Primary Care Providers
Number of participants with documentation of advance care planning within the electronic health record by primary care provider. Preintervention data collected from a chart review after participant enrolled in study.
Time frame: 12 months pre intervention, up to month 6 post intervention
Rate of Advance Care Planning Billing Code Usage
Number of participants with advance care planning billing code usage (CPT codes 99497, 99498; HCPCS codes 1123, 1124). Data collected from a chart review after participant enrolled in study.
Time frame: 12 months pre intervention, up to month 6 post intervention
Rate of Documented Designated Surrogate Decision Maker
Number of participants with a documented designated surrogate decision maker in the electronic health record. Data collected from a chart review after participant enrolled in study.
Time frame: 12 months pre intervention, month 6 post intervention
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