{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:10:28Z","timestamp":1760145028839},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,5,1]]},"abstract":"<jats:p>Objective Health care proxy (HCP) documentation is suboptimal. To improve rates of proxy selection and documentation, we sought to develop and evaluate a web-based interview to guide patients in their selection, and to capture their choices in their electronic health record (EHR).<\/jats:p>\n               <jats:p>Methods We developed and implemented a HCP interview within the patient portal of a large academic health system. We analyzed the experience, together with demographic and clinical factors, of the first 200 patients who used the portal to complete the interview. We invited users to comment about their experience and analyzed their comments using established qualitative methods.<\/jats:p>\n               <jats:p>Results From January 20, 2015 to March 13, 2015, 139 of the 200 patients who completed the interview submitted their HCP information for their clinician to review in the EHR. These patients had a median age of 57 years (Inter Quartile Range (IQR) 45\u201367) and most were healthy. The 99 patients who did not previously have HCP information in their EHR were more likely to complete and then submit their information than the 101 patients who previously had a proxy in their health record (odds ratio 2.4, P\u2009=\u2009.005). Qualitative analysis identified several ways in which the portal-based interview reminded, encouraged, and facilitated patients to complete their HCP.<\/jats:p>\n               <jats:p>Conclusions Patients found our online interview convenient and helpful in facilitating selection and documentation of an HCP. Our study demonstrates that a web-based interview to collect and share a patient\u2019s HCP information is both feasible and useful.<\/jats:p>","DOI":"10.1093\/jamia\/ocv133","type":"journal-article","created":{"date-parts":[[2015,11,15]],"date-time":"2015-11-15T01:18:38Z","timestamp":1447550318000},"page":"580-587","source":"Crossref","is-referenced-by-count":15,"title":["Improving health care proxy documentation using a web-based interview through a patient portal"],"prefix":"10.1093","volume":"23","author":[{"given":"Adarsha S","family":"Bajracharya","sequence":"first","affiliation":[{"name":"Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, USA"}]},{"given":"Bradley H","family":"Crotty","sequence":"additional","affiliation":[{"name":"Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, USA"}]},{"given":"Hollis B","family":"Kowaloff","sequence":"additional","affiliation":[{"name":"Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, USA"}]},{"given":"Charles","family":"Safran","sequence":"additional","affiliation":[{"name":"Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, USA"}]},{"given":"Warner V","family":"Slack","sequence":"additional","affiliation":[{"name":"Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, USA"}]}],"member":"286","published-online":{"date-parts":[[2015,11,13]]},"reference":[{"issue":"7","key":"2020110612441314500_ocv133-B1","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1177\/1049909112463116","article-title":"An Evaluation of 2 Online Advance Directive Programs","volume":"30","author":"Klugman","year":"2013","journal-title":"Am J Hosp Palliat Med."},{"issue":"13","key":"2020110612441314500_ocv133-B2","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1056\/NEJMsa0907901","article-title":"Advance directives and outcomes of surrogate decision making before death","volume":"362","author":"Silveira","year":"2010","journal-title":"N Engl J Med."},{"issue":"4","key":"2020110612441314500_ocv133-B3","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1111\/jgs.12736","article-title":"Advance directive completion by elderly Americans: a decade of change","volume":"62","author":"Silveira","year":"2014","journal-title":"J Am Geriatr Soc."},{"issue":"2","key":"2020110612441314500_ocv133-B4","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1111\/j.1532-5415.2007.01045.x","article-title":"Association between advance directives and quality of end-of-life care: a national study","volume":"55","author":"Teno","year":"2007","journal-title":"J Am Geriatr Soc."},{"issue":"2","key":"2020110612441314500_ocv133-B5","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/j.1532-5415.2007.01065.x","article-title":"Completing an advance directive in the primary care setting: what do we need for success?","volume":"55","author":"Ramsaroop","year":"2007","journal-title":"J Am Geriatr Soc."},{"key":"2020110612441314500_ocv133-B6"},{"issue":"5","key":"2020110612441314500_ocv133-B7","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.amjmed.2004.03.027","article-title":"Improving completion of advance directives in the primary care setting: a randomized controlled trial","volume":"117","author":"Heiman","year":"2004","journal-title":"Am J Med."},{"issue":"4","key":"2020110612441314500_ocv133-B8","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1177\/1049909110386045","article-title":"Clinical decision support technology to increase advance care planning in the primary care setting","volume":"28","author":"Tung","year":"2011","journal-title":"Am J Hosp Palliat Care."},{"issue":"6","key":"2020110612441314500_ocv133-B9","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1177\/0898264315569458","article-title":"Patient-physician end-of-life discussions in the routine care of medicare beneficiaries","volume":"27","author":"Keary","year":"2015","journal-title":"J Aging Health."},{"issue":"2","key":"2020110612441314500_ocv133-B10","doi-asserted-by":"crossref","first-page":"102","DOI":"10.7326\/0003-4819-128-2-199801150-00005","article-title":"Effectiveness of computer-generated reminders for increasing discussions about advance directives and completion of advance directive forms a randomized, controlled trial","volume":"128","author":"Dexter","year":"1998","journal-title":"Ann Intern Med."},{"issue":"6","key":"2020110612441314500_ocv133-B11","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1089\/jpm.2011.0489","article-title":"Reliability of an interactive computer program for advance care planning","volume":"15","author":"Schubart","year":"2012","journal-title":"J Palliat Med."},{"key":"2020110612441314500_ocv133-B12"},{"key":"2020110612441314500_ocv133-B13"},{"issue":"3","key":"2020110612441314500_ocv133-B14","first-page":"234","article-title":"Systematic review of educational interventions for improving advance directive completion","volume":"42","author":"Durbin","year":"2010","journal-title":"J Nurs Scholarsh Off Publ Sigma Theta Tau Int Honor Soc Nurs Sigma Theta Tau."},{"issue":"6","key":"2020110612441314500_ocv133-B15","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.outlook.2012.08.005","article-title":"The era of \u201ce\u201d: The use of new technologies in advance care planning","volume":"60","author":"Green","year":"2012","journal-title":"Nurs Outlook."},{"issue":"4","key":"2020110612441314500_ocv133-B16","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1056\/NEJM196601272740406","article-title":"A computer-based medical-history system","volume":"274","author":"Slack","year":"1966","journal-title":"N Engl J Med."},{"issue":"5","key":"2020110612441314500_ocv133-B17","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/0010-4809(68)90018-9","article-title":"Patient reaction to computer-based medical interviewing","volume":"1","author":"Slack","year":"1968","journal-title":"Comput Biomed Res Int J."},{"issue":"24","key":"2020110612441314500_ocv133-B18","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1056\/NEJM197206152862408","article-title":"Patient-computer dialogue","volume":"286","author":"Slack","year":"1972","journal-title":"N Engl J Med."},{"key":"2020110612441314500_ocv133-B19","first-page":"12","article-title":"Be well!: a computer-based health care interview for hospital personnel","volume-title":"Proc Annu Symp Comput Appl Sic Med Care Symp Comput Appl Med Care","author":"Slack","year":"1993"},{"issue":"4","key":"2020110612441314500_ocv133-B20","first-page":"545","article-title":"Evaluation of computer-based medical histories taken by patients at home","volume":"19","author":"Slack","year":"2012","journal-title":"JAMIA."},{"issue":"7","key":"2020110612441314500_ocv133-B21","first-page":"39","article-title":"Improving care with an automated patient history","volume":"14","author":"Bachman","year":"2007","journal-title":"Fam Pract Manag."},{"issue":"12","key":"2020110612441314500_ocv133-B22","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1176\/ajp.130.12.1327","article-title":"A computer interview for suicide-risk prediction","volume":"130","author":"Greist","year":"1973","journal-title":"Am J Psychiatry."},{"issue":"6036","key":"2020110612441314500_ocv133-B23","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1136\/bmj.2.6036.623","article-title":"Computer interrogation of patients","volume":"2","author":"Lucas","year":"1976","journal-title":"Br Med J."},{"issue":"5365","key":"2020110612441314500_ocv133-B24","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1126\/science.280.5365.867","article-title":"Adolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology","volume":"280","author":"Turner","year":"1998","journal-title":"Science."},{"issue":"12","key":"2020110612441314500_ocv133-B25","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1097\/01.olq.0000145855.36181.13","article-title":"A comparison between audio computer-assisted self-interviews and clinician interviews for obtaining the sexual history","volume":"31","author":"Kurth","year":"2004","journal-title":"Sex Transm Dis."},{"issue":"10","key":"2020110612441314500_ocv133-B26","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1001\/jama.1992.03490100099034","article-title":"Computer-based interview for screening blood donors for risk of HIV transmission","volume":"268","author":"Locke","year":"1992","journal-title":"JAMA."},{"issue":"4","key":"2020110612441314500_ocv133-B27","first-page":"751","article-title":"How outcomes are achieved through patient portals: a realist review","volume":"21","author":"Otte-Trojel","year":"2014","journal-title":"JAMIA."},{"issue":"4","key":"2020110612441314500_ocv133-B28","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1007\/s11606-011-1889-0","article-title":"The association between personal health record use and diabetes quality measures","volume":"27","author":"Tenforde","year":"2012","journal-title":"J Gen Intern Med."},{"issue":"3","key":"2020110612441314500_ocv133-B29","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1001\/jama.2010.2011","article-title":"A vision for patient-centered health information systems","volume":"305","author":"Krist","year":"2011","journal-title":"JAMA."},{"issue":"7","key":"2020110612441314500_ocv133-B30","doi-asserted-by":"crossref","first-page":"e002931","DOI":"10.1136\/bmjopen-2013-002931","article-title":"How patients want to engage with their personal health record: a qualitative study","volume":"3","author":"Kerns","year":"2013","journal-title":"BMJ Open."},{"issue":"12","key":"2020110612441314500_ocv133-B31","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1056\/NEJM198503213121205","article-title":"Clinical computing in a teaching hospital","volume":"312","author":"Bleich","year":"1985","journal-title":"N Engl J Med."},{"issue":"4-5","key":"2020110612441314500_ocv133-B32","first-page":"308","article-title":"Online medical records: a decade of experience","volume":"38","author":"Safran","year":"1999","journal-title":"Methods Inf Med."},{"key":"2020110612441314500_ocv133-B33","first-page":"20","volume-title":"Consumer informatics: Applications and Strategies in Cyber Health Care New York","author":"PatientSite: Patient-Centered Communication, Services, and Access to Information","year":"2004"},{"key":"2020110612441314500_ocv133-B34"},{"issue":"1","key":"2020110612441314500_ocv133-B35","first-page":"1","article-title":"Early experiences with personal health records","volume":"15","author":"Halamka","year":"2008","journal-title":"JAMIA."},{"issue":"1","key":"2020110612441314500_ocv133-B36","first-page":"73","article-title":"Test-retest reliability in a computer-based medical history","volume":"18","author":"Slack","year":"2011","journal-title":"JAMIA."},{"issue":"5","key":"2020110612441314500_ocv133-B37","first-page":"52","article-title":"A history of computerized medical interviews","volume":"1","author":"Slack","year":"1984","journal-title":"MD Comput Comput Med Pract."},{"issue":"18","key":"2020110612441314500_ocv133-B38","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.1001\/jama.292.18.2255","article-title":"A 67-year-old man who e-mails his physician","volume":"292","author":"Slack","year":"2004","journal-title":"JAMA."},{"issue":"8","key":"2020110612441314500_ocv133-B39","doi-asserted-by":"crossref","first-page":"701","DOI":"10.4065\/mcp.2010.0412","article-title":"Patient-computer dialogue: a hope for the future","volume":"85","author":"Slack","year":"2010","journal-title":"Mayo Clin Proc Mayo Clin."},{"key":"2020110612441314500_ocv133-B40","first-page":"38","article-title":"Cybermedicine as a patient\u2019s assistant","volume-title":"Cybermedicine: how computing empowers doctors and patients for better health care","author":"Slack","year":"2001"},{"issue":"2","key":"2020110612441314500_ocv133-B41","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/0010-4809(78)90028-9","article-title":"Converse: a means to write, edit, administer, and summarize computer-based dialogue","volume":"11","author":"Bloom","year":"1978","journal-title":"Comput Biomed Res Int J."},{"key":"2020110612441314500_ocv133-B42"},{"key":"2020110612441314500_ocv133-B43"},{"key":"2020110612441314500_ocv133-B44"},{"issue":"1","key":"2020110612441314500_ocv133-B45","first-page":"91","article-title":"Who uses the patient internet portal? The PatientSite experience","volume":"13","author":"Weingart","year":"2006","journal-title":"JAMIA."}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jamia\/article\/23\/3\/580\/2908993","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jamia\/article\/23\/3\/580\/2908993","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T18:18:19Z","timestamp":1604686699000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/23\/3\/580\/2908993"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11,13]]},"references-count":45,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2015,11,13]]},"published-print":{"date-parts":[[2016,5,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocv133","relation":{},"ISSN":["1067-5027","1527-974X"],"issn-type":[{"value":"1067-5027","type":"print"},{"value":"1527-974X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,11,13]]}}}