Vynca, Cerner Integrate Advance Care Plans Into Electronic Health Records

Advance care planning solutions company Vynca has entered into a partnership with health care technology provider Cerner Corp. (NASDAQ: CERN) in which the companies will integrate goals of care documents with electronic health records (EHR). Making advance care plans available via EHRs can help ensure goal concordant care for patients as well as boost hospice utilization if individuals or their designated surrogates decide against aggressive treatment.

Advance care plans are a key tool in ensuring that patient choices are known and honored during the course of their serious or terminal illnesses. Often, the hard copy documents are not available or are lost before they can reach clinicians, resulting in the patient receiving treatment they may not have chosen. Including those documents in the EHR could go a long way towards eliminating this concern.

“We have partnered with [Cerner] because they have identified and we have identified this opportunity to be able to integrate our solutions to support high-quality advanced care planning,” Vynca CEO Ryan Van Wert, M.D. told Hospice News. “This is going to be from the lens of supporting individuals, their families, caregivers, and their clinicians as they go through this process with the ultimate goal that their future care preferences are honored. By virtue of the scale of Cerner, this furthers our mission of ensuring widespread availability of advanced care planning documentation as well.”

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Along with societal and economic factors related to greater acceptance of hospice and palliative care and the need to reduce health care costs, the availability of Medicare reimbursement is driving renewed interest in promoting advance care plans among health care providers, policymakers and payers.

As Cerner marketed its EHR system, the company received questions from clients as to how they can keep essential patient documentation in a single place, including advance care plans. In response to those questions the company began a year-long process to find a partner that could help them integrate those records into their existing systems.

“We started in about November of last year where we evaluated several vendors in this space and brought together an internal stakeholder unit at Cerner to evaluate those vendors. After a very thoughtful and thorough evaluation, we landed on Vynca to be our strategic partner, and then have been negotiating those business terms and contracts the last six months or so,” Hannah Luetke-Stahlman, lead solution strategist for Cerner, told Hospice News. “We saw an increasing need across our client base to have end-of-life conversations, really try to normalize those and have them be more upstream.”

A cottage industry has sprung up in recent years around advance care planning services, with a number of companies offering patients consulting services or technology to aid them through the process.

Research indicates that advance care planning can reduce hospitalizations by as much as 26%, reduce health care costs, increase community-based palliative care and hospice utilization, as well as significantly increase the likelihood that care will be delivered in accordance with the patient’s wishes.

Despite the benefits of advance care planning, many patients don’t pursue it or pursue it too late. Only 14% of patients with serious illnesses have advance care plans. Patients who choose to receive palliative care are the most likely to have a plan.

The COVID-19 pandemic has also brought the significance of advance care planning into sharp relief, as many COVID patients become unable to communicate before making their end-of-life wishes known. 

“With the timing in the marketplace with a pandemic, the good news is that we were well on a path [to the partnership] prior to the beginning of March when the pandemic started, but I think it’s been an  opportunity to reinforce and emphasize the need for these decisions, and for the decisions to be documented in a way that is basically ubiquitous for organizations,” said Adam Laskey, vice president, Long-Term and Post-Acute Care at Cerner. “We’ve all heard stories around individuals that have progressed in their disease in an accelerated timeline through COVID and didn’t have some of these wishes documented. That becomes a really challenging  moral question for health care systems and organizations.”

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