The next step for Advanced Care Planning Decisions in their work to help patients make end-of-life decisions is to embed patient video into an electronic medical record to make advanced directives crystal clear.
Dr. Angelo Volandes said this iteration of the project will help family members as well as doctors understand exactly how much care a person wants at the end of life.
“Death panels were all about doctors pulling the plug on Grandma,” he said. “These videos will put the patient in control and allow Grandma to tell the doctor, ‘Don’t put the plug in.'”
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Volandes spoke on a panel about digital hospitals Monday at SXSW, along with Dr. Joseph Kvedar and Paul Griffiths.
An audience member said that he and his wife have very similar advance directives, but his spouse said she would be willing to stay in intensive care for a few days longer than he would.
“Video advance directives will allow doctors to see facial muscles and to hear the inflection of a person’s voice, and get a better understanding of those nuances,” Volandes said.
Volandes’ site has a collection of videos that explain the options for end-of-life care for people who have advanced dementia or advanced cancer. Researchers used these videos in a study to compare the effects of a verbal conversation about treatment vs. these videos.
Patients who watched the videos were much more likely to choose less care than people who had only a conversation about treatment options.
Volandes is working with about 35 health systems to use the videos in conversations with patients. He said that working with each EHR vendor takes time and that it will probably be next summer before the video files will be available for the medical records.
“It will take a little longer to implement, but the overwhelming response that we’ve gotten shows that people are very willing to make a video of end-of-life directives,” he said.
