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Advance Care Planning & Technology

It’s National Advance Care Planning Week (1-5 April, 2019) and in our training, we talk about how you can now upload an Advance Care Plan to My Health Record which means, hopefully, the patient’s wishes will be easily accessible when needed.

We are often asked the following questions in regard to Advance Care Plans:

  1. Why don’t healthcare providers have Advance Care Plans on their list of My Health Record documents in the clinical software like Event Summaries & Shared Health Summaries?
    Our answer to this one might not be 100% accurate but the way we explain it is: In our software currently there is 1 (official CDA format) Shared Health Summary template, 1 Event Summary template etc however our understanding is there are different care planning documents for different states of Australia. To create a single template or even gain agreement on the format for use on My Health Record is a significant process. In the meantime, the system operators have allowed people to upload their own version themselves. This enables people to upload any format (Word or PDF documents, even scanned scrappy, handwritten notes) but at least they represent the person’s wishes and can be accessed by health care providers at the point of care. There is no time to waste here.

    Which leads to the second question:
  2. How do elderly people who may not be IT savvy, add their Advance Care Plans to their My Health Record? Easiest answer: They get someone to help them. Hopefully they have a lovely family member or close friend who can assist however medical practices might also have some ideas of how we can help patients needing some assistance?

Click here for detailed instructions on how to upload an Advance Care plan to a patient’s My Health Record:

Katrina’s True Story:

My parents are in their 80’s and ageing in the home. I helped them upload their Advance Care Plans to their My Health Records. I helped them set up their choice of documents and privacy controls (dad does not care at all and does not want to access it himself, mum does care and loves to access her health information on her iPad).

They also allowed me to be their ‘Authorised Representative’ which means I can see their My Health Records (on my iPad from anywhere in the world). This is proving to be helpful as they age as they live in a country town and I live in Sydney. If there is an admission to hospital I can look at the test results and discharge summary on their My Health Record myself.

Katrina’s Wishlist:

  1. We can have a telehealth/teleconference with the medical care team and family and that this service is Medicare rebatable.
  2. The Emergency Dept clinicians look at my parents’ Shared Health Summaries with my parents when they present rather than making them try to remember all their history and medications when they are already in such distress.
  3. My Health Record quickly becomes so embedded into their wonderful GP’s routine workflow that she remembers to upload a new shared health summary every time she changes their medication or adds a new diagnosis. Patients forget to ask, GP’s forget to upload. It’s understandable. We’re thinking an inbuilt reactive software prompt might be helpful. We’d love to hear your ideas?

Next Steps

With the federal government budget announcements this week including increased funding for our patients with complex health needs it is time to start thinking of our frequent flyers ie those patients for whom we are ‘their doctor’ and ‘their practice’.

How might formalising this ‘registration’ process look?

How might ‘flexible consultations’ in your practice look?

What are some quality improvements you could implement to improve care options for your patients who are over 70?

It’s time to think outside the square and adopt an innovative, patient-centred approach.

I’d also like to leave you with a link to a wonderful podcast I listened to this week by Dr Merran Cooper, founder of Touchstone Life Care. She chats with Peter Birch from ‘Talking Healthtech’ about how technology can be an enabler of a healthy death. She’s changed the way I think about this topic most of us usually like to avoid talking about.


National Advance Care Planning week

Advance Care Planning: Be Open, Be ready, Be Heard- Advance Care Planning Australia

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