Do Electronic Medical Records Improve Advance Directive Documentation? A Systematic Review

The American Journal of Hospice & Palliative Care
Christopher LemonMohamed Khadra

Abstract

Documentation rates of advance directives (ADs) remain low. Using electronic medical records (EMRs) could help, but a synthesis of evidence is currently lacking. To evaluate the evidence for using EMRs in documenting ADs and its implications for overcoming challenges associated with their use. Systematic review of articles in English, published from inception of databases to December 2017. PubMed, PsycINFO, EMBASE, and CINAHL. Four databases were searched from inception to December 2017. Randomized and nonrandomized quantitative studies examining the effects of EMRs on creation, storage, or use of ADs were included. All featured an advance care planning process. Evidence was evaluated using the Cochrane Collaboration's risk assessment tool. Fifteen studies were included: 1 randomized controlled trial, 1 randomized pilot, 4 pre-post studies, 4 cross-sectional studies, 1 retrospective cohort study, 1 historical control study, 1 retrospective observational study, 1 retrospective review, and 1 evaluation of an EMR feature. Seven studies showed that EMR-based reminders, AD templates, and decision aids can improve AD documentation rates. Three demonstrated that EMR search functions, decision aids, and automatic identification softwar...Continue Reading

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Citations

Aug 21, 2020·The American Journal of Hospice & Palliative Care·Cristine B HenageEllen Roberts
Feb 5, 2021·British Journal of Community Nursing·Libby SampeyJuliet Spiller
Apr 8, 2021·NPJ Digital Medicine·Anne M FinucaneClaudia Pagliari
Dec 29, 2021·The American Journal of Hospice & Palliative Care·Callie M BerkowitzRowena J Dolor

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