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National Hospice and Palliative Care Month: The Role of Advance Care Planning in Optimizing Care Quality

By 11/19/2020 No Comments

The theme for this year’s National Hospice and Palliative Care Month is “It’s About How You Live.” The goal of the observance is to raise awareness for how hospice and palliative care provide high-quality care that enables patients and their loved ones to focus on living full lives that align with their goals and values while facing serious illness.

Six in 10 American adults have a chronic disease, with 40% having two or more chronic diseases. Most people with life-limiting ailments want to prioritize the quality of time over quantity, which is a central tenet of hospice and palliative care. According to the latest data from the National Hospice and Palliative Care Organization (NHPCO), 1.55 million Medicare beneficiaries chose to receive hospice care in 2018. Additionally, once people are informed about palliative care and what is, 92% report they would be highly likely to consider palliative care for themselves or their family if they had a serious illness.

Palliative and hospice care provide patients with the resources to alleviate the symptoms and stress of their serious illness and to properly plan for their desired care in the future. Only one in three U.S. adults completes any type of advance directive for end-of-life care, and JAMA Internal Medicine reports that 70% of forms do not reflect patient wishes. In some cases, end-of-life directives are only discovered after a patient has died. In many instances, providers do not even ask patients what type of care they want or share all of the options.

Advance care planning is a true gateway for people who would opt for hospice and palliative care services, as high-quality conversations take place, giving individuals the knowledge and power to decide the medical care they want near or at the end of life. Vynca’s solutions and services help individuals, their caregivers and clinicians navigate the complex process of making choices for future care preferences, along with the technology to make these choices digitally available, to ensure these preferences are known and honored. The inspiration for Vynca came from my own experiences as an intensive care physician, witnessing cases in which patients with a serious, life-limiting illness received aggressive care in the ICU against their wishes because care planning documents, such as advance directives and POLST forms, were not available to help guide the care team. By digitizing and personalizing advance care planning, Vynca reduces the complexity of engaging in meaningful advance care planning conversations and enables the completion of digital, actionable documents for high-quality, goal concordant care.

Digitally completed documents through Vynca’s have been proven to be of higher quality than those completed on paper. During the pandemic, healthcare organizations leveraged Vynca more than ever, leading to an increase in documents initiated by a preparer (up to 27% from 14%), a 41% reduction in hospital admissions when a digital document was viewed in the emergency department versus a scanned document, and an increase in ePOLST completion rates (up to 53% from 42%).

With another wave of COVID-19 upon us, the risk of requiring life support is increasing dramatically among those who are older and suffer from chronic illness. As a result, there is a greater need to conduct active outreach to these high-risk populations to initiate advance care planning conversations.  

Vynca helps facilitate the crucial dialogues and documents that ultimately provide patients with access to hospice and palliative care services. By leveraging our solutions and services, healthcare providers are better prepared to guide high-quality conversations, empowering patients to make their voices heard, resulting in care that truly reflects patient wishes.

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