Advance directives are documents that outline a person’s end-of-life care and treatment preferences so healthcare providers, family, friends and caregivers know what decisions should be made and can put the patient’s wishes first to improve end-of-life care. Advance directive documents in Arizona include a living will, health care power of attorney, mental health care power of attorney and pre-hospital medical care directive (also known as a Do Not Resuscitate, or DNR).
During the 2019 legislative session, Arizona Senate Bill 1352 was passed giving healthcare providers the ability to have real-time access to patients’ wishes – when they need it most. The bill improves provider access to advance directives by moving Arizona’s advance directives registry from its original location within the Secretary of State’s office to Health Current, Arizona’s Health Information Exchange.
Since 2007, Health Current, a Contexture organization, has worked to become Arizona’s primary resource for information technology and exchange, integrating information with the delivery of care to improve the health and well-being of individuals and communities. And now, Health Current is the new home for the Arizona Healthcare Directives Registry (AzHDR).
Health Current’s management of the registry is not just to meet all required technical criteria, but to comprehensively change the state’s paradigm for creating, capturing and retrieving advance directives. The AzHDR is designed to help honor patients’ end-of-life healthcare wishes by providing seamless access to advance directives across the continuum of care. The new secure online AzHDR provides a safe place to store and make accessible Arizonans’ advance directive documents so end-of-life care will be guided by their wishes.
Registering advance directives with the AzHDR is free to Arizona residents, provides peace of mind to registrants and offers easy access to participating healthcare providers–ensuring wishes registered are wishes honored.
Moreover, proper set up and use of advance directives have been reported in peer-reviewed literature to have led to successful outcomes in reducing hospital admissions, ICU utilization and in-hospital deaths, and increasing hospice care.
The COVID-19 pandemic has illuminated the critical importance of ensuring individuals have made their personal values and end-of-life preferences known and readily available. In response to being asked for her perspective, one emergency room physician stated, “I really wanted to bring awareness to some important topics that haven’t been well covered in the media, which are really being highlighted by this crisis, and that is advance care planning and for people to start thinking about what they would want done if they become acutely ill.”
While there has been an existing need for a registry that allows real-time access to frontline responders on healthcare directives, the need has been exacerbated by the pandemic. Sarah Ascher, associate vice president, End of Life Care Partnership, United Way of Tucson and Southern Arizona, spoke to the good that is coming out of this most unprecedented time: “The awareness of the need for advance directives has risen, both among patients and the healthcare provider community. The AzHDR and Health Current are key to our work in helping break down silos to ensure people receive the care they desire at the end of life.”
Working together as a community can ensure that no matter where or when someone faces the moment they cannot communicate, their advance directives are registered, accessible and honored.