ArticleJournal of the American Medical Informatics Association : JAMIA2016
An information model for automated assessment of concordance between advance care preferences and care delivered near the end of life.
Article in Journal of the American Medical Informatics Association : JAMIA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed.
- Care Consistency With Care Preferences in Nursing Homes: A Cluster-Randomized Study of the Effects of an Advance Care Planning Program (BEVOR).Deutsches Arzteblatt international · 2025Trial
- Advance care planning in patients with incurable cancer: study protocol for a randomised controlled trial.BMJ open · 2016Trial
- Clinical Decision Support Leveraging Health Information Exchange Improves Concordance with Patients' Resuscitation Orders and End-of-Life Wishes.Applied clinical informatics · 2025Article
- Communication, Shared Decision-making and Goals of Care in the ICU through Electronic Health Records: A Scoping Review.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Measuring Goal-Concordant Care in Palliative Care Research.Journal of pain and symptom management · 2021Review
- Exploring and reconciling discordance between documented and preferred resuscitation preferences for hospitalized patients: a quality improvement study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2021Article
- Patient-centered care and the electronic health record: exploring functionality and gaps.JAMIA open · 2020Article
- Patient Preferences in the Medical Product Life Cycle: What do Stakeholders Think? Semi-Structured Qualitative Interviews in Europe and the USA.The patient · 2019Article
- Using Electronic Health Records for Quality Measurement and Accountability in Care of the Seriously Ill: Opportunities and Challenges.Journal of palliative medicine · 2018Article
- Clinical Informatics Researcher's Desiderata for the Data Content of the Next Generation Electronic Health Record.Applied clinical informatics · 2017Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo develop an information model for automating evaluation of concordance between patient preferences and end-of-life care.
methodsWe modeled and validated 15 end-of-life care preference option domains, to which we mapped preferences recorded in standardized advance care planning documents and 232 end-of-life care events defined by procedure and medication codes. Patient preferences and end-of-life care events were available in electronic health records. Data from Kaiser Permanente Southern California modeling and testing populations were evaluated for concordance between patients' preferences and the end-of-life care events they experienced.
resultsThe information model successfully assessed concordance between patient preferences and end-of-life care events. Among 388 expired patients in the modeling population, 4164 care events occurred, 4100 (98%) of which were preference-concordant, and 64 (2%) of which were preference-discordant. Including end-of-life care events that did not occur increased the number of observations to 6029; 99% were preference-concordant. At the level of individuals, 72% (278) of patients experienced only preference-concordant care events, 13% (50) experienced at least one preference-discordant care event, and 15% (60) experienced no preference-related care events. DISCUSSION: Model limitations pertain to assumptions that are required to match advance care planning documents with patient preference options and exclusion of preferred care that did not occur. Further research is required to apply the model to larger populations and to investigate the need for additional preference options.
conclusionAn information model for automating the assessment of the concordance between patients' advance care planning preferences and the end-of-life care they received was effective in a small population and has the potential to assess population-level preference-concordance on an ongoing basis.
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