ArticleThe American journal of hospice & palliative care2017
Provider Perspectives on Advance Care Planning Documentation in the Electronic Health Record: The Experience of Primary Care Providers and Specialists Using Advance Health-Care Directives and Physician Orders for Life-Sustaining Treatment.
Article in The American journal of hospice & palliative care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 47 citations in OpenAlex.
- Advance Care Planning in Patients Nearing the End of Life: A Pre-intervention Study of Racial Disparities and Provider Factors.Journal of general internal medicine · 2026Article
- How Older Adults Use Digital Technologies for Healthcare? A Systematic Scoping Review.Journal of medical systems · 2026Article
- The Age-Friendly Learning Healthcare System: Replicating electronic health record based documentation metrics for 4Ms care.Journal of the American Geriatrics Society · 2025Article
- A Framework to Optimize Primary Care of Older Surgical Patients: A Qualitative Study of Geriatricians.JAMA network open · 2025Article
- Facilitator and Barrier to Health Information System Use from Health Professionals Perspective: A Scoping Review.Journal of multidisciplinary healthcare · 2025Review
- Association between physician age and patterns of end-of-life care among older Americans.Journal of the American Geriatrics Society · 2024Article
- Characteristics of international primary care practices and physicians related to advance care planning: a cross-sectional survey study.BMC primary care · 2023Article
- Electronic Health Records' Support for Primary Care Physicians' Situation Awareness: A Metanarrative Review.Human factors · 2023Review
- Serious Illness Conversation Training for Inpatient Medical Oncology Advanced Practice Providers: A Quality Improvement Project.Journal of the advanced practitioner in oncology · 2023Article
- Goals of care documentation by medical oncologists and oncology patient end-of-life care outcomes.Cancer · 2022Article
- Accessibility of information on patients' and family members' end-of-life wishes in advance care planning.Nursing open · 2022Article
- English and Spanish-speaking vulnerable older adults report many barriers to advance care planning.Journal of the American Geriatrics Society · 2021Article
- A Quality Improvement Initiative to Increase Completion and Documentation of Advanced Directives in the ICU at a U.S. Community Teaching Hospital.Critical care explorations · 2021Article
- Using Implementation Science to Further the Adoption and Implementation of Advance Care Planning in Rural Primary Care.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2020Review
- Estimating the Impact of Words Used by Physicians in Advance Care Planning Discussions: The "Do You Want Everything Done?" Effect.Critical care explorations · 2019Article
- Giving Voice to Patient Values Throughout Cancer: A Novel Nurse-Led Intervention.Journal of pain and symptom management · 2019Article
- A systematic review of the use of the electronic health record for patient identification, communication, and clinical support in palliative care.JAMIA open · 2018Article
- Advance Care Planning and End-of-Life Decision Making for Patients with Cancer.Seminars in oncology nursing · 2018Review
- Community-Based Palliative Care and Advance Care Planning Documentation: Evidence from a Multispecialty Group.Journal of the American Geriatrics Society · 2018Observational
- Clinician Perspectives on Group Visits for Advance Care Planning Among Caregivers and Older Adult Patients With Heart Failure.Journal of the American Board of Family Medicine : JABFMArticle
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
contextAdvance care planning (ACP) is valued by patients and clinicians, yet documenting ACP in an accessible manner is problematic.
objectivesIn order to understand how providers incorporate electronic health record (EHR) ACP documentation into clinical practice, we interviewed providers in primary care and specialty departments about ACP practices (n = 13) and analyzed EHR data on 358 primary care providers (PCPs) and 79 specialists at a large multispecialty group practice.
methodsStructured interviews were conducted with 13 providers with high and low rates of ACP documentation in primary care, oncology, pulmonology, and cardiology departments. The EHR problem list data on Advance Health Care Directives (AHCDs) and Physician Orders for Life-Sustaining Treatment (POLST) were used to calculate ACP documentation rates.
resultsExamining seriously ill patients ≥65 years with no preexisting ACP documentation seen by providers during 2013 to 2014, 88.6% (AHCD) and 91.1% (POLST) of 79 specialists had zero ACP documentations. Of 358 PCPs, 29.1% (AHCD) and 62.3% (POLST) had zero ACP documentations. Interviewed PCPs often believed ACP documentation was beneficial and accessible, while specialists more often did not. Specialists expressed more confusion about documenting ACP, whereas PCPs reported standard clinic workflows. Problems with interoperability between outpatient and inpatient EHR systems and lack of consensus about who should document ACP were sources of variations in practices.
conclusionResults suggest that providers desire standardized workflows for ACP discussion and documentation. New Medicare reimbursement for ACP and an increasing number of quality metrics for ACP are incentives for health-care systems to address barriers to ACP documentation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.