Errors in Electronic Health Record Advance Care Planning Documentation: It’s a Patient Safety Issue

Abstract

Background: Centralized locations in the electronic health record (EHR) improve access to advance care planning (ACP) information; however, the prevalence of documentation errors in these locations is unknown.

Methods: In this cross-sectional study, we included primary care patients aged ≥65 years or ≥18 years with a serious illness. We verified errors using keyword queries and categorized them as “Patient Safety Errors” (e.g., ACP not in the centralized location) or “Noise Errors” (e.g., non-ACP in the centralized location). Associations between patient characteristics and errors versus no errors were evaluated using bivariate analysis.

Results: Among 10,767 patients, 5374 (49.9%) had ACP in their EHR, and 495 (9.2%) of those had a verified error; 32.9% were Patient Safety Errors. Patients with errors were more likely to self-identify as from a minoritized population, be non-English speaking, and have a serious illness (p < 0.001).

Discussion: Identifying documentation errors can help health systems create solutions for reliably scanning and storing patients’ wishes and decreasing disparities.

Randa, S. N., Nouri, S., Walling, A. M., Patel, K., Cheng, M. K. W., Ritchie, C. S., Li, B., Vanegas, G., Cardoso, E., & Sudore, R. L. (2025). Errors in electronic health record advance care planning documentation: It’s a patient safety issue. Journal of Palliative Medicine. Advance online publication. https://doi.org/10.1177/10966218251395440