--- title: "Palliative care & advance care planning documentation. | Sutter Health" description: "Only a small percentage of individuals with serious illnesses had ACP documentation in the EHR. Palliative care service use was assoc with higher rates of ACP." url: "https://www.sutterhealth.org/research/publications/palliative-care-advance-care-planning-documentation-1055312325" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Palliative care & advance care planning documentation. # Community-based palliative care and advance care planning documentation: evidence from a multispecialty group. Tai-Seale M, Yang Y, Dillon E, Tapper S, Lai S, Yu P, Allore H, & Ritchie C. _J Am Geriatr Soc. 2018 Feb;66(2):327-332. doi: 10.1111/jgs.15145. Epub 2017 Oct 24._ 2017-10-24 ## Abstract BACKGROUND/OBJECTIVES: With the growing public demand for access to critical health data across care settings, it is essential that advance care planning (ACP) information be included in the electronic health record (EHR) so that multiple clinicians can access it and understand individuals' preferences for end-of-life care. Community-based palliative care programs often incorporate ACP services. This study examined whether a community-based palliative care program is associated with digitally extractable ACP documentation in the EHR. DESIGN: Observational study using propensity score-weighted generalized estimation equations to examine patterns of digitally extractable ACP documentation. SETTING: Palo Alto Medical Foundation (PAMF), a multispecialty ambulatory healthcare system in northern California.PARTICIPANTS: Individuals aged 65 and older with serious illnesses between January 1, 2013, and December 31, 2014 (N = 3,444). INTERVENTION: Community-based palliative care program in PAMF. MEASUREMENTS: Digitally extractable ACP in EHR. RESULTS: We found that only 14% (n = 483) of individuals with serious illnesses had digitally extractable ACP in electronic health records. Of the 6% of individuals receiving palliative care, 65% had ACP, versus 11% of those not receiving palliative care. Study results showed a strong positive association between palliative care and ACP. CONCLUSION: Only a small percentage of individuals with serious illnesses had ACP documentation in the EHR. Individuals with serious illnesses infrequently used palliative care delivered by board-certified palliative care specialists. Palliative care service use was associated with higher rates of ACP after controlling for organizational and individual characteristics using a propensity score weighting method. Scalable interventions targeted at non-palliative care clinicians for universal access to ACP are needed. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/29063601) ## Research topics - [Aging and Longevity](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Aging+and+Longevity%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Impact of home-based, patient-centered support for people with advanced illness in an open health system: a retrospective claims analysis of health expenditures, utilization, and quality of care at end of life.](https://www.sutterhealth.org/research/publications/impact-of-palliative-care-program-cost-use-qol-1055312725) Sudat SEK, Franco A, Pressman AR, Rosenfeld K, Gornet E, Stewart W. Palliat Med. 2018 Feb;32(2):485-492. doi: 10.1177/0269216317711824. Epub 2017 Jun 7. 2018 Feb 01 - Publication ### [Advance care planning in older adults with multiple chronic conditions undergoing high-risk surgery.](https://www.sutterhealth.org/research/publications/advance-care-plans-with-seniors-and-high-risk-surgery-1055312419) Tang VL, Dillon EC, Yang Y, Tai-Seale M, Boscardin J, Kata A, Sudore RL. JAMA Surg. doi: 10.1001/jamasurg.2018.4647. \[Epub ahead of print\] 2018 Dec 05 - Publication ### [Patient experiences in selecting a Medicare Part D prescription drug plan.](https://www.sutterhealth.org/research/publications/pt-experiences-selecting-medicare-part-d-rx-drug-plan-1055312300) Stults CD, Baskin AS, Bundorf MK, Tai-Seale M. J Patient Experience. https://doi.org/10.1177/2374373517739413 2017 Nov 21 - Publication ### [Predicting need for advanced illness or palliative care in a primary care population using electronic health record data.](https://www.sutterhealth.org/research/publications/predict-need-for-palliative-care-in-primary-care-with-ehrs-1055312675) Jung K, Sudat SEK, Kwon N, Stewart WF, Shan NH. J Biomed Inform. 92:103115. 2019 Apr 01 - Publication ### [Comparative usability study of a newly created patient-centered tool and Medicare.gov plan finder to help Medicare beneficiaries choose prescription drug plans.](https://www.sutterhealth.org/research/publications/pt-centered-drug-plan-finder-vs-medicaregov-1055312687) Stults CD, Fattahi S, Meehan A, Bundorf MK, Chan AS, Pun T, Tai-Seale M. J Patient Exp. 6(1):81-86. doi: 10.1177/2374373518778343. Epub 2018 Jun 6. 2019 Mar 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/palliative-care-advance-care-planning-documentation-1055312325#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Palliative care & advance care planning documentation."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/palliative-care-advance-care-planning-documentation-1055312325#medicalscholarlyarticle","name":"Community-based palliative care and advance care planning documentation: evidence from a multispecialty group.","headline":"Palliative care & advance care planning documentation.","abstract":"BACKGROUND/OBJECTIVES: With the growing public demand for access to critical health data across care settings, it is essential that advance care planning (ACP) information be included in the electronic health record (EHR) so that multiple clinicians can access it and understand individuals' preferences for end-of-life care. Community-based palliative care programs often incorporate ACP services. This study examined whether a community-based palliative care program is associated with digitally extractable ACP documentation in the EHR. DESIGN: Observational study using propensity score-weighted generalized estimation equations to examine patterns of digitally extractable ACP documentation. SETTING: Palo Alto Medical Foundation (PAMF), a multispecialty ambulatory healthcare system in northern California.PARTICIPANTS: Individuals aged 65 and older with serious illnesses between January 1, 2013, and December 31, 2014 (N = 3,444). INTERVENTION: Community-based palliative care program in PAMF. MEASUREMENTS: Digitally extractable ACP in EHR. RESULTS: We found that only 14% (n = 483) of individuals with serious illnesses had digitally extractable ACP in electronic health records. Of the 6% of individuals receiving palliative care, 65% had ACP, versus 11% of those not receiving palliative care. Study results showed a strong positive association between palliative care and ACP. CONCLUSION: Only a small percentage of individuals with serious illnesses had ACP documentation in the EHR. Individuals with serious illnesses infrequently used palliative care delivered by board-certified palliative care specialists. Palliative care service use was associated with higher rates of ACP after controlling for organizational and individual characteristics using a propensity score weighting method. Scalable interventions targeted at non-palliative care clinicians for universal access to ACP are needed.","description":"Only a small percentage of individuals with serious illnesses had ACP documentation in the EHR. 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