An Evaluation of 2 Online Advance Directive Programs

Since 1995, studies have shown mixed results in the efficacy of advance directives. With new technologies, advance care planning is being transformed through video, computer programs, electronic registries, and electronic health records. In Nevada and Texas, Web sites and mobile applications provide education, guided interviews, storage, and retrieval in multiple languages. Drawing on 371 completed evaluations from both states, the authors show that increasingly people are finding advance directive information on the Internet, completing directives to be prepared and to have control, and that the attraction of these Web sites is their ease of use. Users report where they keep their documents, with whom they have end-of-life conversations, and what medical care requests they make.