The Registry is the solution to the health care provider’s problem of how to effectively manage advance directives. How to document compliance with federal and state regulations about advance directives? How to store and retrieve them easily? How to share documents efficiently among the various facilities in a health system or hospital group? How to know if the document on file is up to date and still reflects the patient’s wishes? How to seamlessly and reliably make storage and retrieval work with your electronic medical record system?

The Registry can help you solve all of these problems with a scalable, low-cost solution that is compatible with all medical record systems using the most recent version of the FHIR standard.

How It Works

The U.S. Advance Care Plan Registry® is a secure, on-line database containing advance directives and organ donor information. There are a wide range of participation opportunities for health care providers of all sizes, from individual doctor’s offices, to nation-wide hospital systems.

  • Registrants complete a Registration Agreement that gives the Registry permission to send a copy of their document to any health care provider (hospitals, doctors, skilled nursing facilities, nursing facilities, home health agencies, providers of home health care, ambulatory surgery centers, and hospices). The Registry agrees not to release their information to any party other than health care providers, so their personal information is kept private and confidential, just like a medical record.  
  • The advance directive document is scanned and electronically stored in the Registry’s cloud based database along with their emergency contact information.  The database is housed in a state of the art data center with back up power supply, Internet connections and the most up to date security measures.  The scanning can be done at the health care facility, or the document can be securely emailed, faxed or mailed to the Registry and our staff will scan and/or upload the document.  
  • Registration is confirmed with a letter to the new registrant that contains labels to affix to their insurance card & driver’s license, stating that their advance directive is registered, and a wallet card listing their Registration #. The Provider’s name is prominently listed on this letter, reminding the registrant that they are receiving this service as a benefit from the Provider. This is a great goodwill marketing tool for the Provider. An on-line account is also established, which the registrant can use to access and make changes to their personal information and download, fax or email their document as needed. They can even upload a new document if their wishes change.  This ensures that the healthcare provider always has the most recent version of the document available. Registrants can also use the free mobile app (Apple and Android) to view, email or fax their document. 
  • Registrants are emailed annually to confirm that their wishes have not been changed or revoked, and to update personal and emergency contact information. They are reminded to make changes to personal or emergency contact information using their on-line account. The Provider’s name is also listed prominently in the reminder message. Registrants can also certify that their document is up to date and still reflects their wishes from the on-line account. The date of this certification is provided as a “Last Updated” date whenever the document is accessed. In this way, there is no doubt as to whether the document still reflects their wishes. This annual update reminder is included with the registration.  
  • Member health care providers have secure, 24 hour, direct access to the database to download documents. They can search by name and birth date to access a patient’s document, or to simply check to see if any patient has a document on file. The downloaded document also contains the date the document was last updated or confirmed. In this way, the document remains up to date and documented to still reflect the registrant’s wishes as of that date.  
  • The Registry is compatible with any electronic medical record system…it works as an application with a simple click on a menu item. Different privilege levels are available to customize access for different employees. Authentication into your hospital network automatically authenticates access to the Registry and all user actions are logged. Detailed reports can be easily generated to document compliance with HIPAA and other federal and state regulations.  The Registry can also be integrated into your electronic medical record system using the most recent version of the FHIR standard.  While some health systems utilize their electronic medical record system (EMR) for storage of advance care plan documents, storage in the EMR is static.  The patient does not have access to their document to make changes, and there is no way for the provider to know that they have the most recent version of the document on file.  Storage in the Registry database allows the document and information to be dynamic.  The patient has access to their information and document, and can update them as needed.
  • There are two Mobile Apps that make access to documents easy.  A Mobile App for Emergency Personnel allows emergency responders to search for a document by address, thereby allowing emergency personnel to view a document such as a DNR or POLST prior to arriving at the scene.  There is also a Registrant Mobile App that allows a registrant to view, download, fax or email their document directly from their smartphone.  
  • Health care providers that are not members of the Registry can access documents via secure Internet site, by entering the Registration # from the wallet card. If the wallet card is not available, they can obtain the document by phone. The Provider simply contacts the Registry by phone, and provides information about their facility and about the person whose document they are trying to retrieve. Registry personnel will perform a manual transmission of the document. Non-member health care providers do not have direct access to the database to download or search for documents.  
  • Because health care providers have documents on file already, and because some patients will choose not to sign the Registration Agreement, the Registry has developed a method whereby the health care facility can store and manage ALL documents in the Registry…those with a Registration Agreement, as well as those without one. Documents without a Registration Agreement are stored in the Living Vault. The Living Vault is a proprietary and patent protected method of storing documents so that access to them is restricted based on different criteria. See the FAQ for healthcare providers for a detailed description of the Living Vault. In this way, a provider can store and manage ALL advance directives, providing a comprehensive solution to the storage and retrieval of these important documents and helping to comply with federal and state regulations.

They will have peace of mind knowing that their advance directive is safe, secure, and available to family and doctors whenever and wherever it is needed. Because providers can simply contact the Registry to see if any patient has an advance directive, they can still retrieve a document, even if the wallet card is not available.

Some people feel uncomfortable giving their advance directive document to their health insurance company or to the federal government. U.S. Advance Care Plan Registry® is an independent organization that simply stores documents securely and makes them available when needed…the Registry has nothing to do with paying for health care, so there is no conflict of interest.

Your patients will appreciate the peace of mind afforded by knowing that their wishes will be available to health care providers whenever and wherever they are needed. They will be thankful for the opportunity to take the heavy burden of decision-making off of their families.. Your hospital or health system will have an efficient, low-cost and effective way to easily manage advance directives.

There are many different levels of participation available to meet any budget…we have programs in place for individual doctors’ offices and for nation-wide health systems. Contact us today for more information.

Born of Necessity…

U.S. Advance Care Plan Registry® was founded by Joseph T. Barmakian, M.D., a New Jersey Board Certified Orthopedic Surgeon. Dr. Barmakian has witnessed the ordeal of patients’ families as they confront the painful, guilt-ridden decisions of life support and medical treatment. He has also felt the frustration of doctors who don’t have access to patients’ wishes. It was in 1996 that Dr. Barmakian first recognized the need for a registry service that not only recorded patients’ advance directives, but also made it easier for health care facilities to obtain the information. Dr. Barmakian felt it was critical to establish a system which provides medical personnel and patient’s families with advance directives whenever and wherever they are needed while maintaining the patient’s privacy and confidentiality. U.S. Advance Care Plan Registry® fulfills these criteria, providing easy, 24-hour access to patients’ wishes.