Use of Digital Tools Improves Access to and Delivery of Advance Care Planning

HOUSTON, Dec. 7, 2023 /PRNewswire/ -- Koda Health is pleased to share that research published in the Journal of the American Board of Family Medicine shows digital platforms may provide considerable benefits beyond traditional forms of advance care planning (ACP), including enabling more equitable access to ACP, helping health providers offer comprehensive ACP, and improving patient engagement with ACP.

Through ACP, individuals of any age or health status determine and share their values, quality of life priorities, health goals, and treatment preferences. ACP has been shown to help ensure patients' preferences are fulfilled, reduce anxiety among loved ones, improve patient quality of life, decrease unwanted utilization of medical services, and increase appropriate hospice utilization. Studies also demonstrated that ACP leads to substantial healthcare savings.

Despite these benefits, ACP uptake is often low, with contributing factors including patients' lack of knowledge about ACP and providers' difficulty in initiating discussions with patients.

"Many patients expect their doctor to bring up ACP, but providers don't always receive sufficient training to feel comfortable with these discussions, or they simply lack time. Evidence-based, online resources can easily be introduced in the clinic, and doctors can trust that patients can make informed decisions," says R. Lynae Roberts, PhD, lead author and a research scientist with Koda Health, developer of the Koda Health ACP software platform. The cloud-based platform enables individuals to create detailed advance care plans.

Roberts; Desh Mohan, MD, chief medical officer of Koda; and colleagues retrospectively examined data from pilot deployment of the Koda ACP platform among Houston Methodist Coordinated Care (HMCC) patients. HMCC is an accountable care organization participating in an enhanced track Medicare shared savings program (MSSP).

HMCC nurse navigators were trained on introducing Koda ACP tools to a subset of higher risk MSSP patients who had not previously completed ACP, were at increased health risk, or lacked advance directives. This patient introduction to Koda occurred during routine telephone outreach to provide education and longitudinal healthcare navigation.

Patients who expressed interest in completing an ACP were provided a link (emailed or printed on marketing material) to the Koda ACP platform where they could access and complete their ACP documentation and then share the legal documentation generated. Koda's patient support associates periodically followed up with referred patients.

From November 2020 to April 2022, 203 eligible patients were enrolled into Koda ACP. Analysis of the data by Roberts et al. found:

• Patient engagement rates were well above published national ACP completion rate from traditional processes, with nearly 53% of eligible patients voluntarily completing ACPs.
• Engagement and completion rates were similar across demographics — a key finding given that studies have previously demonstrated inequities in rates of ACP discussions and documentation among historically marginalized groups.
• Most patients indicated a preference toward spending the last days of life at home and wanting no life-support intervention if quality of life became unacceptable.

"When ill patients are unable to voice their wishes, loved ones must make difficult decisions," says Mohan. "Without ACP, this burden can be devastating, but with prior discussions and documentation, families can be assured that they are making choices the patient want."

About Koda Health

Koda Health builds tools to make difficult healthcare conversations simple. Supported by the National Science Foundation, Texas Medical Center, and Techstars United Healthcare, Koda's flagship advance care planning (ACP) software platform provides clinicians the ability to engage patients in valuable conversations about care preferences. Through Koda, patients have a single source to explore their values, identify a surrogate decision-maker, define their quality of life, indicate treatments that matter, and complete and share advance directives — all without burdening their care team.

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SOURCE Koda Health