Physicians have a hard time finding end-of-life wishes in EHRs

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Although EHRs are commonplace, many clinicians find it challenging to find patients' end-of-life care wishes in the electronic system, according to the Star Tribune.

EHRs can store patients' end-of-life care preferences, whether they be avoiding resuscitation or ventilators. But according to an unnamed May 2016 study cited in the report, less than one-third of emergency room physicians feel confident they could locate end-of-life wishes in an EHR. Another unnamed study from 2013 cited in the article uncovered patients' end-of-life care choices are often stored in multiple locations within an EHR.

Professionals agree with the studies' findings. "Weirdly, there is not a handy or consistent place to put these things in an electronic health record," said Marian Grant, DNP, MSN, BSN, RN, an associate professor at Baltimore-based University of Maryland School of Nursing.

"We have had a challenge in that electronic medical records ... are not really built to optimize finding plans about end-of-life wishes," said Joshua Lakin, MD, of Boston-based Harvard Medical School's Center for Palliative Care.

Dr. Lakin mentioned one organization — La Crosse, Wis.-based Gundersen Lutheran Medical Center — that keeps its patients' end-of-life wishes easily accessible in the EHR. Gundersen Lutheran implemented its Epic EHR in 2008. Throughout the adoption process, the hospital worked closely with Epic to ensure end-of-life care-related documents can easily be found via a tab that links to advance care planning information.

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