One of the difficulties of advance care preparation is ensuring that prescribing physicians have access to an up-to-date copy of pertinent records, such as advance care directives.
Associate Professor Joel Rhee, Chair of the RACGP Specific Interests Cancer and Palliative Care, believes this. Better integration of My Health Record, on the other hand, might be a workaround.
Advance treatment preparation records put in My Health Record would increase [patients'] proximity to acute care providers and other health practitioners when critical clinical choices are to be taken.
Enabling patients to upload these records into My Health Record on their own is a move in the right direction.
The Australian Digital Health Agency (ADHA) has issued a new series of national recommendations to assist healthcare professionals in assisting patients who want to apply advanced care planning documentation to their My Health Record in honor of National Advance Care Planning Week (March 22–26).
The guidelines, established as part of the National Goals of Care Collaborative headed by the ADHA and the Western Australian Department of Health (DoH), outline how to store and access documents relating to advance care preparation and goals of care conversations that exist in the form of end-of-life care.
Dr. Simon Towler is the clinical lead for end-of-life treatment at the Western Australian Department of Health and the Chair of the ADHA's National Goals of Care Steering Committee. He advised newsGP that making this material open and affordable is "important and polite."
Dr. Towler said that it underpins best practice and is consistent with the ADHA's pledge to improve treatment models.
Because all Australians today have a My Health Record, and health providers are constantly accessing [these] while delivering services, there is a far greater incentive to ensure that a person's deliberate desires and expectations for treatment, as well as their life decisions, will be recognised and taken into consideration.
According to him, the recommendations have the power to ‘significantly assist' patients and healthcare providers in making well-informed, collaborative decisions.
Dr. Towler said that this is polite, it is common practice, and it should be the benchmark for all healthcare.
While connecting advanced treatment arrangements with My Health Record will help certain people, Associate Professor Rhee believes that it cannot benefit others who are less acquainted with technology and the internet.
[However], the [new ADHA] guidelines through help to close this gap by allowing GPs to assist their patients by uploading advance care planning documents on their behalf.
Advance care preparation materials put in the My Health Record... can also help to deter scenarios when someone is trying to locate the most recent copy of the related documents, which may be attached to the patient's fridge, secured, or lawyer's office, which is closed for the weekend.
My Health Record has provided a discrete, readily identifiable platform to archive and display the documents, which can be viewed by the patient and their healthcare staff regardless of venue.
This is especially significant for people who access treatment in a variety of contexts and procedures, utilise both public and private health systems, and move often.
The National System for Early Care Preparation, Advance Care Planning Australia, and Palliative Care Australia have also recommended using My Health Record to hold documents relating to advance care planning and priorities of treatment conversations that exist in the sense of end-of-life care.
However, Associate Professor Rhee believes that the gains will only be realised if any component of the structure functions properly.
This implies smooth convergence between hospital and practice-based electronic medical record programs with the My Health Record system's advance care planning capabilities,' he said.
[It includes] patients downloading records on their own behalf, or GPs uploading them on their behalf – if this feature is accessible – and intensive care physicians searching My Health Record for a backup of appropriate documents.
My Health Record is often not the sole source of records for advance treatment preparation, but rather one potential storage tool.
According to the ADHA guidelines, a health practitioner ‘can upload a person's advance care preparation documents or priorities of treatment documents related to end-of-life care to a person's My Health Record if the individual instructs'. However, this necessitates that the healthcare applications utilised by the health service be configured to accommodate this feature.
If in doubt, Associate Professor Rhee advises practices to consult with their tech vendor.
He said that hopefully, the vendors of popular GP clinical applications would introduce features that will enable GPs to assist their patients by uploading advance care planning information on their behalf.
According to an ADHA spokesperson, the department actually has little insight about when tech vendors can introduce the upgrades, but it is ‘on their radar.'
Dr. Towler affirmed that this is a critical job. It would require time and effort to ensure that the procedure is smooth and that patients are well supported.
Aside from administration and accessibility, Associate Professor Rhee has repeatedly argued that making the dialogue is the most critical part of advance care preparation.
He asked what are the patient's treatment priorities and preferences?
‘What is the patient's degree of awareness about their own wellbeing and prognosis? Are [the] patient's treatment objectives realistic? What steps should be taken to guarantee that potential healthcare reflects the patient's treatment goals and preferences?
Advance treatment preparation is often an important way to explore whether the patient has any unmet healthcare requirements. There is a selection of excellent opportunities created especially for Australian general practitioners.
The RACGP's policy statement on advance care planning encourages its incorporation into standard general practice, and its Silver Book offers clinically relevant alternatives to advance care planning.
