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Do Electronic Medical Records Improve Advance Directive Documentation? A Systematic Review
Christopher Lemon1, Michael De Ridder2,3, Mohamed Khadra3,4
1University of Notre Dame Australia, Sydney, School of Medicine, Sydney, NSW, Australia.
The American Journal of Hospice & Palliative Care
|September 1, 2018
Summary
Electronic medical records (EMRs) show promise for improving advance directive (AD) documentation rates. However, evidence is limited, and EMRs may introduce new challenges in AD management.
Area of Science:
- Health Informatics
- Medical Documentation
- Advance Care Planning
Background:
- Advance directive (AD) documentation rates are persistently low.
- Electronic medical records (EMRs) offer potential solutions, but evidence synthesis is lacking.
Purpose of the Study:
- To systematically review evidence on using EMRs for AD documentation.
- To assess the impact of EMRs on AD documentation challenges.
Main Methods:
- Systematic review of 15 studies (inception-2017) from four databases (PubMed, PsycINFO, EMBASE, CINAHL).
- Included randomized and nonrandomized quantitative studies on EMRs and ADs within advance care planning.
- Assessed risk of bias using Cochrane Collaboration's tool.
Main Results:
- Seven studies indicated EMR features (reminders, templates, decision aids) improve AD documentation.
- Three studies showed EMRs can help identify patients with or needing ADs.
- Five studies highlighted EMRs can create challenges in locating ADs and equitable documentation.
Conclusions:
- Limited evidence suggests EMRs can aid AD documentation but may also pose challenges.
- Further robust research is required to confirm EMRs' role in population-level AD documentation improvement.
Keywords:
advance care planningadvance directiveselectronic health recordsliving willsmedical informaticsmedical records systemsright to dieMore Related Videos
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