• Daniela Lamas, Natalie Panariello, Natalie Henrich, Bernard Hammes, Laura C Hanson, Diane E Meier, Nancy Guinn, Janet Corrigan, Sean Hubber, Hannah Luetke-Stahlman, and Susan Block.
• 1 Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital , Boston, Massachusetts.
• J Palliat Med. 2018 Apr 1; 21 (4): 522-528.

ObjectiveTo develop a set of clinically relevant recommendations to improve the state of advance care planning (ACP) documentation in the electronic health record (EHR).BackgroundAdvance care planning (ACP) is a key process that supports goal-concordant care. For preferences to be honored, clinicians must be able to reliably record, find, and use ACP documentation. However, there are no standards to guide ACP documentation in the electronic health record (EHR).MethodsWe interviewed 21 key informants to understand the strengths and weaknesses of EHR documentation systems for ACP and identify best practices. We analyzed these interviews using a qualitative content analysis approach and subsequently developed a preliminary set of recommendations. These recommendations were vetted and refined in a second round of input from a national panel of content experts.ResultsInformants identified six themes regarding current inadequacies in documentation and accessibility of ACP information and opportunities for improvement.DiscussionWe offer a set of concise, clinically relevant recommendations, informed by expert opinion, to improve the state of ACP documentation in the EHR.

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