New Survey: Advance Care Planning Is Unfamiliar to Many Americans, Few Have Plans in Place

Despite Emotional Barriers, Majority Want Providers to Initiate Conversations

ARLINGTON, Va., July 15, 2025 /PRNewswire/ -- Only 5% of Americans have an advance care plan in place, and half (50%) are largely unfamiliar with the concept, according to a recent survey conducted by The Harris Poll and commissioned by health technology innovator Backline by DrFirst. The research reveals significant emotional and practical hurdles, yet a strong desire for healthcare provider guidance.

"Advance care planning can be a sensitive topic, but it's crucial that these conversations happen," said Colin Banas, M.D., chief medical officer for Backline by DrFirst. "I tell patients it's one of the most meaningful gifts you can give your loved ones, sparing them the burden of making difficult decisions during a medical emergency. This data makes it clear that people want guidance, support and simpler ways to take that first step."

Advance care planning is the process of deciding and communicating future medical care preferences, regardless of age or current health status. It involves personal reflection, discussions with loved ones and providers, and designating a healthcare agent to ensure wishes are followed. Plans should be documented, shared and reviewed periodically.

Key Backline by DrFirst/Harris Poll Findings Include: 

Limited Familiarity: 

• 50% of Americans are either not at all familiar (29%) or only know the name (21%) advance care planning.

Emotional and Practical Barriers:

• 63% find thinking about advance care planning emotionally difficult.
  
  
• 57% believe it is complicated and/or time-consuming.
  
  
• 34% mistakenly think it's only needed for certain groups of people (e.g., very sick, terminally ill, 65 years of age or older).

Confidence in Loved One's Knowledge:

• While 74% have confidence that their family knows their healthcare wishes if they can't speak for themselves, only 30% are strongly confident.
  
  
• 26% lack confidence, with 8% strongly feeling loved ones would not know their preferences.

Desire for Provider-Initiated Discussions:

• 66% of Americans want their healthcare provider to initiate advance care planning conversations. This desire is even higher among parents of children under age 18 (74%) compared to those who don't have children under age 18 (63%).

"While few have an advance care plan, it's encouraging that two-thirds want their providers to bring up the subject," Banas added. "However, given the emotional difficulty and perceptions of it being complicated and time-consuming, simply bringing up the topic won't be enough. New technology can now bridge this gap, making it easier for patients to document their preferences for family and providers."

To help address these barriers, Backline by DrFirst has partnered with Five Wishes and MyDirectives to introduce ACP Complete. This end-to-end advance care planning solution combines secure communication tools, guided documentation and access to digital advance directive forms.

"By removing barriers and making advance care planning more approachable, Backline and its partners aim to empower more Americans to take control of their healthcare future," said Banas.

About Backline by DrFirst
Backline by DrFirst is an industry-leading communications ecosystem that empowers forward-thinking healthcare organizations to deliver exceptional care to patients anywhere, improving patient outcomes while reducing operational costs. Backline's team of IT experts, engineers, nurses, doctors, and hospital CIOs is engaged in a mission to improve healthcare for all. Headquartered in Arlington, Virginia, the Backline team has provided HIPAA-compliant communication solutions for the healthcare sector for more than 10 years. To learn more, visit backlinehealth.com or follow us on LinkedIn and X.

About the Backline by Backline by DrFirst /Harris Poll Survey
This survey was conducted online within the U.S. by The Harris Poll on behalf of Backline by DrFirst from April 29 - May 1, 2025, among 2,098 adults ages 18 and older. The sampling precision of Harris online polls is measured by using a Bayesian credible interval. For this study, the sample data is accurate to within +/- 2.5 percentage points using a 95% confidence level. For complete survey methodology, including weighting variables and subgroup sample sizes, please contact [email protected].

Media Contact:
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SOURCE DrFirst