Perceptions of Patient Portal Use for Advance Directive Documentation Among Older Adults with Multiple Chronic Conditions (S715)

Abstract

•Discuss two methods for using patient portals for advance directives.•Apply three technological design recommendations for advance directive patient portal tools. Advance directives (AD) are frequently under-recorded in electronic medical records (EMR). Technology can play a role in facilitating AD documentation using patient portals, secure websites for personal health information and provider resources directly linked to an EMR. Although older adults with multiple chronic conditions are a target group for AD documentation, little is known about their opinions regarding AD documentation via patient portals. Assess perceptions about using patient portals for ADs. Qualitative focus groups with Kaiser Permanente Colorado patients ≥65 years, with a Carlson Comorbidity Index score ≥2, both patient portal users and non-users, identified using stratified random sampling. Six structured focus groups were completed, audio-taped, and transcribed. Participants were asked about portal functionality including uploading ADs directly into the EMR and portal design preferences to promote AD documentation. We used inductive open coding and patterned analysis to analyze data. Twenty-four participants were mean 78±5.4 years of age and 70% female. The majority had completed an AD. Participants were not aware of AD resources available on the patient portal, and some explained they would not upload an AD due to security concerns and preferences to keep their ADs with family. Participants interested in using the portal for AD documentation emphasized the importance of professional assistance, location of AD information on the portal, and access to their current AD as key elements for design. Some older adults may be reluctant to use a patient portal for AD documentation, while others are likely to use a portal for ADs with proper portal design and support.