SBIR-STTR Award

Widely publicized cases such as Terri Schiavo have raised awareness of the importance of advance care planning. However, while promoted through federal law and regulation, emphasis is placed on the completion of an advance directive (AD) document rather than on the informed decision making and communication essential to ensuring that end of life care preferences are honored. In fact, there is little evidence that having an AD alone results in improved or preferred care at the end of life. Consequently, the advance directive (or living will) as a public policy instrument has been called a failed social policy. Recently attention has been redirected to the process of advance care planning. In response, we propose an innovative interactive decision aid to help individuals not only make informed decisions about preferred treatment at end of life but also to communicate these preferences and decisions to their health care providers and families. The program will use video to provide visual depiction of several advance stage health states and options for end of life care treatment and to model effective communication with health care providers and family about preferences for care. Template documents for completing an AD and health care proxy will be provided for completion immediately or at a later date. The program will be presented on a tablet-PC, with the capability to be web-based allowing the inclusion of these documents in an electronic medical record. No other available program offers all of these features on a portable platform to maximize and facilitate use across a range of settings The Specific Aims of Phase I are to: 1) develop a content outline for the full program; 2) develop the design and format of the program; 3) develop a script and storyboard for one partial program module; 4) develop this section (prototype) for delivery on a tablet PC; 5) conduct a feasibility evaluation of the prototype; and 6) develop a plan and schedule for production of the full-length program in Phase II. PROJECT NARRATIVE Advance care planning is more than signing a document. It is a process. This interactive decision aide will help individuals not only make informed decisions about preferred treatment at end of life but also to communicate these preferences and decisions to their health care providers and families. The program will use video to present several advance stage health states and options for end of life care treatment and to model communication with health care providers and family about preferences for care.

Public Health Relevance:
This Public Health Relevance is not available.

Thesaurus Terms:
There Are No Thesaurus Terms On File For This Project.

Widely publicized cases such as Terri Schiavo have raised awareness of the importance of advance care planning. However, while promoted through federal law and regulation, emphasis is placed on the completion of an advance directive (AD) document rather than on the informed decision making and communication essential to ensuring that end of life care preferences are honored. In fact, there is little evidence that having an AD alone results in improved or preferred care at the end of life. Consequently, the advance directive (or living will) as a public policy instrument has been called a failed social policy. More recently, attention has been redirected to the process of advance care planning. In response, we propose an innovative interactive decision aid to help individuals not only to make informed decisions about preferred treatment at end of life but also to communicate these preferences and decisions to their health care providers and families. The program will use video to provide visual depiction of several advance stage health states and options for end of life care treatment and to model effective communication with health care providers and family about preferences for care. Template documents for completing an AD and health care proxy will be provided for completion immediately or at a later date. The program is presented on a tablet-PC, with the capability to be web-based allowing the inclusion of these documents in an electronic medical record. No other available program offers all of these features on a portable platform to maximize and facilitate use across a range of settings The Specific Aims of Phase I were completed successfully. The Specific Aims of Phase II are to: 1) produce the final two dramatic videos regarding patient communication with family and a health care proxy; 2) produce digital videos for additional health states and potential treatment options; 3) finalize web design and complete programming of text screens and integration of video and audio narration; 4) evaluation of the program's effectiveness; and 5) finalization and implementation of the commercialization plan.

Public Health Relevance:
Advance care planning is more than signing a document. It is a process. This interactive decision aide will help individuals not only make informed decisions about preferred treatment at end of life but also to communicate these preferences and decisions to their health care providers and families. The program will use video to present several advance stage health states and options for end of life care treatment and to model communication with health care providers and family about preferences for care.

Thesaurus Terms:
Advance Care Planning; Advance Directives; Advance Health Care Planning; Attention; Awareness; Awarenesses; Care, Health; Caring; Communication; Computerized Medical Record; Computers; Decision Aid; Decision Aids; Decision Making; Electronic Medical Record; End Of Life Care; Ensure; Evaluation; Family; Goals; Health; Health Care Providers; Health Personnel; Healthcare; Healthcare Providers; Healthcare Worker; Individual; Internet; Laws; Length; Living Wills; Medical Record, Computerized; Modeling; Movement; Narration; On-Line Systems; Online Systems; Patients; Persons; Phase; Process; Production; Program Effectiveness; Programs (Pt); Programs [publication Type]; Proxy; Public Policy; Regulation; Sched; Schedule; Social Policies; Staging; Txt; Tablets; Text; Visual; Www; Advanced Directive; Body Movement; Care Preference; Commercialization; Design; Designing; Digital; End Of Life; Experience; Health Care Personnel; Health Care Worker; Health Literacy; Health Provider; Healthcare Personnel; Improved; Innovate; Innovation; Innovative; Instrument; Medical Personnel; Online Computer; Preference; Programs; Prototype; Public Health Relevance; Response; Tablet (Pharmacologic); Touch Panel; Touch Screen; Touch Screen Panel; Touchscreen; Touchscreen Panel; Treatment Provider; Web; Web Based; World Wide Web