Comments on: Should advance directives be stored online on Google Health?

By: GingerB

GingerB — Thu, 13 Aug 2009 16:27:34 +0000

I have an advanced directive and I’ll be keeping it on paper with a copy for my loved ones. I’m OK with an automated system noting that I have one — a real live person can inquire to my family about it if the circumstance dictates.

By: Nuclear Fire

Nuclear Fire — Thu, 13 Aug 2009 01:47:11 +0000

How myopic to call this an EPIC fail. Maybe it would be not that helpful for the ER doc (hard to believe) but how about the admitting intensivist or internist. People hardly ever (ok, never) show up with their advanced directives but as Ambulance Driver stated, the information could be placed on a medical alert bracelet along with other important information. They even make DNR/DNI bracelets. Sounds like a good start to me.

Besides, nothing is an EPIC fail like the EPIC emr.

By: Dr. K

Dr. K — Wed, 12 Aug 2009 21:31:40 +0000

I think Google advance directives is one useful tool. The patient should give his login info/password to his POA and any other close family/friends he feels comfortable having access to his medical records. He can give a paper copy to his primary care doc, and have it in his wallet “in case of emergency”. I know that if he is hospitalized and a paper copy is given to my local hospital at the time of admission, it will then be a part of his permanent medical record and readily available on future admisssions. All these things together increase the chances of someone finding the info in an urgent situation. I have had hospitals outside my area call me( the primary care physcian) when my patient is unconcious and on life support outside my “jurisdiction”. This has allowed the patient to be taken off life support and treated in a more comfortable and dignified manner per the patient’s advance directives.

By: Doc99

Doc99 — Wed, 12 Aug 2009 19:34:02 +0000

Here’s a situation in which a Medical Smart Card, akin to the ATM card, would be invaluable.

By: Dr. Mintz

Dr. Mintz — Wed, 12 Aug 2009 19:25:25 +0000

We are also forgetting that in addition to physicians who may have access, as Dr. Parkinson mentions, family members may have access to the advanced directives online, if the individual gives them persmission. Hopefully, Google could come up with a way to have certain users (family, caretakers) access to portions of a health record for emergency situations. Advanced directive in Google Health may not be perfect, but this is better than what we currently do, and a step in the right direction. P.S. this is yet another reason why should Let Google Solve Our EMR problems

By: Ambulance Driver

Ambulance Driver — Wed, 12 Aug 2009 19:18:31 +0000

Wear a MedicAlert style bracelet with your Google Health ID and password on it.

By: k

Wed, 12 Aug 2009 18:56:33 +0000

Send a copy of your advance directives to the person to whom you have given health care power of attorney. Depending on how old you are, you might want to have 2 people with HPOA. Keep a copy – perhaps in a safe deposit box – and make sure the person(s) with HPOA also have access to it.

By: Jay Parkinson

Jay Parkinson — Wed, 12 Aug 2009 18:05:07 +0000

Basically we are arguing if an advance directive should be accessible from anywhere via a password protected mechanism. Or, like Danimal states, on a piece of paper somewhere. Since physicians who are given access to their patients’ medical records via Google Health can access their patients’ records via their own password, this can’t be considered an epic fail.
I applaud Google Health for this initiative.

By: Danimal

Danimal — Wed, 12 Aug 2009 17:09:31 +0000

What is the best way to get the word out about an advance directive? My doc has a copy, but that’ll do me little good if I get in an accident and go visit you guys. Should I send a copy around to all the hospitals in my area? Would they bother to keep it on file?

By: Steven Waldren, MD

Steven Waldren, MD — Wed, 12 Aug 2009 16:06:35 +0000

I do not think that use case was the intent for adding Advance Directives to Google Health. In that use case, even if the Advance Directive legal document was in the person’s purse or back pocket it was not be found/used.

What about the use case of being admitted to the hospital? I think the real uses of the Advance Directives in Google Health are to help notify usual and semi-usual sources of care, that an Advance Directive exists and that the care provider should get a copy of the Advance Directive. Then when the patient arrives at the hospital in a comatose state, the Advance Directive could of already been accessed and recorded into the hospital system.

Best,
Steven