Table 1.
Summary of included studies.
| Author(s) | Year | Country | Study design | Population and sample size (n) | Description of system(s) involved | Name of system being described |
|---|---|---|---|---|---|---|
| Auret et al. | 2019 | Australia | Quantitative (observational) | N = 73 (Physicians (n = 26), nurses (n = 15) other HCPs (n = 12), audit of patients (n = 20)) | EHR | NA |
| Brungardt et al. | 2019 | USA | Quantitative (observational) | N = 105 (patients) | EHR | My Health Connection |
| Fin et al. | 2016 | USA | Quantitative (observational) | N = 900 (people who were users of the MyDirectives platform) | Standalone system not involving an EHR | MyDirectives |
| Goodwin et al. | 2021 | New Zealand | Other | N = 3,238 (The findings were obtained from an analysis of a database of 3238 people who had finalised an AC Plan between December 2013 and December 2019.) | EHR | eAC Plans |
| Hall et al. | 2012 | UK (Scotland) | Qualitative | N = 22 (purposive sampling of practice nurses (3 interviews), GPs (12 interviews), a practice manager (1 interview) from practices using different computing software systems and patients and/or carers (6 interviews for whom an ePCS had been completed)) | EHR | Electronic Palliative Care Summaries (ePCSs) |
| Halpert et al. | 2021 | USA | Quantitative (observational) | N = 426 (patients aged 75 years or older who had an upcoming appointment with their provider within 2 weeks and who had no documentation of ACP in their chart) | EHR | Epic EMR, which includes an ACP activity tab |
| Harrington et al. | 2020 | UK (England) | Mixed | N = 159 (data on gerontology inpatients (n = 133) with electronic do not attempt cardiopulmonary resuscitation (e-DNACPR) decisions and survey data from staff (n = 26) including senior and junior doctors, and medical trainees) | EHR | NA |
| Holt et al. | 2019 | USA | Other | NA | Standalone system not involving an EHR | Oregon’s online registry of out-of-hospital DNR orders |
| Jordan et al. | 2019 | USA | Qualitative | N = 46 (patients, mean age: 49, 63% female) | EHR | My Health Connection |
| Klugman et al. | 2013 | USA | Quantitative (observational) | N = 371 (platform users) | Standalone system not involving an EHR | TexasLivingWill.org (TLW), NVLivingWill.com (NVLW) |
| McDarby et al. | 2021 | USA | Other | NA | Other | ACP Tools (iOS and Android) BIDMC Health Care Contingency Plan – Personal MedStar CR My Dot Mediq My Directives My Health Proxy My Living Will Paper Health |
| Millington-Sanders et al. | 2012 | UK | Quantitative (observational) | N = 597 (patients) | Standalone system not involving an EHR | Coordinate My Care (CMC) |
| Mills et al. | 2021 | Australia | Mixed | N = 170 (Medical, nursing, and allied health practitioners working in palliative care) | Standalone system not involving an EHR | MyHealth Record |
| Moses et al. | 2020 | USA | Other | NA | EHR | NA |
| Nakagawa et al. | 2014 | USA | Quantitative (observational) | N = 93 (patients) | EHR | NA |
| Neubauer et al. | 2015 | USA | Quantitative (observational) | N = 5,467 (patients) | EHR | My Choices, My Wishes |
| Obel et al. | 2014 | USA | Quantitative (observational) | N = 48 (patients) | EHR | NA |
| Portz et al. | 2020 | USA | Quantitative (observational) | N = 3292 (UCHealth patients who interacted with the My Health Connection patient portal, advance care planning tools, specifically by completing an electronic MDPOA form or sending an electronic message to the advance care planning support team) | EHR | My Health Connection |
| Portz et al. | 2020 | USA | Qualitative | N = 24 (participants from the KPCO EMR with inclusion criteria included: ≥65 years of age, KPCO member for ≥ 1 year, presence of multiple chronic conditions (Charlson Comorbidity Index > 2), and a patient with one of the participating KPCO study clinics) | EHR | My Health Manager (Kaiser Permanente Colorado’s (KPCO) patient portal) |
| Reidy et al. | 2017 | USA | Mixed | N = 27 (hospitalists, residents, and nurse practitioners on conducting goals-of-care conversations – although other survey work also outlined) | EHR | Luminat |
| Riley et al. | 2013 | UK (England) | Other | NA | Standalone system not involving an EHR | Coordinate My Care |
| Rolnick et al. | 2021 | USA | Quantitative (experimental) | N = 91 (Adults with gastrointestinal and lung malignancies were recruited from the Penn Medicine Infusion Center. 46 randomly allocated to the web AD and 45 to paper) | EHR Plus | Our Care Wishes |
| Saiki et al. | 2017 | USA | Other | NA | EHR | Goals of Care template, as part of TEAM approach (Time, Education, Assessment, and Management) |
| Seecof et al. | 2022 | USA | Other | N = 50 (Patients at the Center for Healthy Aging aged 65 or older without documented ACP in the EMR) | EHR | NA |
| Serrano-Eanelli et al. | 2019 | USA | Other | N = 331 (medical records of patients) | EHR Plus | New York State eMOLST (electronic Medical Order for Life-Sustaining Treatment form) |
| Seuli Bose-Brill et al. | 2016 | USA | Quantitative (experimental) | N = 50 (patients) | EHR Plus | MyChart |
| Shervin Esfahani et al. | 2020 | USA | Other | N = 365 (Retrospective record review of all ICU deaths across the system in 1 year) | EHR | SmartPhrase (a tool in the Epic EMR system) |
| Stepan et al. | 2019 | USA | Other | N = ∼15,600 (patient records of all new patients with a diagnosis of advanced or metastatic cancer who had a documented advance directive and/or ACP conversations with an ambulatory care provider (physicians, fellows, residents, physician assistants, nurse practitioners, nurses, social work counsellors, and chaplains) by their third office visit) | EHR | NA |
| Tieu et al. | 2017 | USA | Quantitative (observational) | N = 200 (patients within the Division of Primary Care Internal Medicine, aged 65 and older, with access to the secure PEM system and without an AD on file, were included for randomization) | EHR Plus | Mayo Clinic Patient Online Services system |
| Walker et al. | 2018 | USA | Quantitative (observational) | N = 414 (primary care patients at the San Francisco Veterans Affairs Medical Center, were $60 years old, and had $2 chronic/serious health conditions) | EHR | Prepare for your care (www.prepareforyourcare.org) |
| Wilson et al. | 2020 | USA | Other | NA | EHR | Epic Systems EMR |
| Wu et al. | 2022 | USA | Quantitative (observational) | N = 187,690 (unique patients 65 years and older with at least one clinical encounter at an SHC outpatient clinic over the study period) | EHR | Epic Systems |
| Wye et al. | 2016 | UK | Mixed | N = 3,594 (Data from 1,022 North Somerset and 2,572 Somerset palliative patients; interview participants = 101 professionals, 49 by telephone, 29 face to face and 23 informally) | EHR | Adastra |
| Zive et al. | 2016 | USA | Other | NA. Intended for those nearing end of life. | EHR | ePOLST |
Key: EHR = Electronic Health Record; EMR = Electronic Medical Record; NA = Not applicable.