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How Healthcare Organizations are Incorporating Advance Care Planning in Response to COVID-19

By 03/30/2020 April 16th, 2020 No Comments

At Vynca, our goal is and has always been to ensure appropriate end-of-life care for every individual. Although this is an extremely crazy time in healthcare, our team is celebrating a milestone this month. For 5 years, Vynca has been live in healthcare organizations across the country. This is a huge accomplishment, and much gratitude must be extended to those of you on the front lines in healthcare. You made this achievement possible. You demanded the best for every individual and worked tirelessly to improve advance care planning at your organization. We are now managing over 1 million care plans and I couldn’t be more thankful for the clients, friends, and team members that led us to this point.

Our team recently hosted a call with healthcare executives across the United States to share and learn how others are leveraging advance care planning (ACP) in response to COVID-19. We heard inspiring stories of quick and decisive decision making to help lessen the strain on hospital resources- mainly answering to the anticipated shortage of ICU beds and ventilators. It was evident through that call, combined with several conversations with clients and friends of Vynca, and witnessing the preparation at the hospital where I practice, we are responding the best we can with the resources, technology, and knowledge available to us.

We know COVID-19 is here, it disproportionately impacts older and immunocompromised populations more severely, and has already made an impact on our ability to deliver high-quality care. While the predictions are arduous, it is important to recognize the impactful strategies healthcare organizations have implemented in order to respond.

Three areas of focus we have seen emerge in response to COVID-19.
As a Pulmonary Critical Care physician, I have been amazed at our collective ability to localize, prepare, and respond to the COVID-19 pandemic with limited resources. These areas of focus highlight the importance of ACP, as proper ACP leads to reduced ED and hospital visits, along with reduced ICU utilization. In times of crisis or not, ACP is imperative to provide wanted, appropriate care to all patients.

Telehealth
We know now is the time to reduce opportunities for the virus to transmit to our most vulnerable patients and care providers. The recent loosened restrictions on telehealth has increased the number of telehealth consults, reducing the risk of transmission. With this, we are seeing an increase in ACP telehealth consults. Through shared decision making, patients clearly define future care preferences, identifying those who might prefer less aggressive treatment should they become ill. Healthcare organizations have said this is critically important as they focus on the appropriate allocation of beds and resources through this crisis. I am proud to say Vynca is working 24/7 to quickly answer to those who have requested our solution to support telehealth, including eSignature, allowing providers to digitally capture ACP documents.

Access to documents in an emergency
During an emergency, patient records and care preferences are imperative to appropriately allocate ICU beds and to avoid overtreatment. When documents are digitally captured, we 1) reduce risk of paper contamination, 2) allow digital access at the point of care, and 3) ensure up-to-date documents are available. We have heard from organizations who are prioritizing an ACP registry for target populations. I am proud of how my team has responded– developing an Emergency ACP eRegistry that can quickly provide ACP access in disparate care settings.

Community engagement
We know ACP conversations are difficult. There are ways to lessen the burden of these difficult conversations and decisions. By using patient-centered documentation and programs, we can build up a community where ACP preferences are effectively and appropriately documented. When key leaders rally behind the importance of ACP, you will experience a positive impact on outreach and document completion rates. It is our duty to better understand patient’s care preferences to appropriately care for the them at the end-of-life. We know this is difficult, but when you make it a community-led effort, big changes happen. Trying to figure out how to get started? I encourage you to review this resource document to see what is readily available in your community. Also, in case you missed my last blog, you can find additional resources available in “The Critical Role of ACP During the Pandemic”.

I know this is a difficult time, but there is no time like the present to take a minute and celebrate the work of others, major milestones, and achievements. Today on National Doctor’s Day, we acknowledge your sacrifice not only through this crisis, but also honor your everyday commitment to patients. You are heroes. Thank you for all you do to provide the best possible care, no matter the personal risk.

To all of you in healthcare, I have been encouraged by our collective response during this time. Take care and please don’t hesitate to reach out. In times of crisis, it is important to learn from each other’s experiences and help out where possible.

Want to know how we can help? Contact us today!

Ryan Van Wert, MD is CEO and Co-founder of Vynca, and a part-time Clinical Assistant Professor at Stanford University.