In his recent blog entry here (Nov. 24), Steve Hartnett, the Academy’s Associate Director of Education, reminds us that sometimes the basic things you do for clients are the most important — in this case, drafting healthcare directives to express and protect clients’ medical wishes.

Steve’s right. These documents (HCPOAs, living wills) are basic – and important.

And it’s only a baby step from here to realize that your clients’ healthcare directives also need to be at the hospital when doctors and clients need them. Otherwise your basic documents are, well, useless.

No problem, you may think, for your clients to have their directives at the hospital? Hardly.

Consider this:

• One study found that doctors did not know that their patients had executed advance directives in 75% of cases in which they had.
• Another study found that advance directives were unavailable at the hospital in 74% of cases when needed.

One solution to this problem: electronic registries. Such registries store advance directives and make them immediately available to hospitals 24/7/365.

In fact, the federal Department of Health and Human Services, in a rulemaking just last month, recognized the problem of advance directives not always being available when needed and identified registries as one solution. HHS observed that registries may be “an appropriate source of the proper documentation in urgent situations” and can also help loved ones “avoid leaving the patient’s bedside” to obtain the needed documents. (Medicare and Medicaid Programs: Changes to the Hospital and Critical Access Hospital Conditions of Participation to Ensure Visitation Rights for All Patients, Final Rule. Federal Register, Vol. 75, No. 223, November 19, 2010.)

So, what constitutes a good registry for your clients? You might be surprised. More on this next time.

Randi J. Siegel, MBA, is the President of DocuBank, the largest advance directive registry in the U.S., which ensures that the healthcare directives of its 175,000 enrollees are immediately available 24/7/365. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. She is active in health policy pertaining to advance directives and serves as a Senior Fellow at the Jefferson School of Population Health in Philadelphia. Randi is an ongoing contributor to the Academy blog.

Academy Guest Blogger
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