ADVault, Inc. and eHealth Exchange Deliver Advance Care Plans Directly Within Electronic Health Records

For Immediate Release: April 16, 2020

For ADVault: Heather Cabral
West End Strategy Team

Dawn Van Dyke                                           
eHealth Exchange                                                    

ADVault, Inc. and eHealth Exchange Deliver Advance Care Plans Directly Within Electronic Health Records

Overwhelmed Providers Can Now Find Person-Generated Goals of Care and COVID-19 Statements in Real-time

VIENNA, VA and DALLAS, TX –– eHealth Exchange, one of the nation’s largest health information networks, announced today its newest network participant, ADVault, Inc., the creators of MyDirectives. The MyDirectives platform allows individuals to upload or create, store and share their advance directives, advance care plans and portable medical orders like POLST forms. Now integrated into eHealth Exchange, the ADVault Exchange™ global repository is accessible by any healthcare provider participating in the eHealth Exchange for the patients they treat. This reduces the burden health organizations face in trying to get this critical information directly from patients or their caregivers during times of crisis.

ADVault also announced that personal COVID-19 statements can now be added as a type of advance care planning document that consumers can store for free in the ADVault Exchange. Now, more than 75 percent of all U.S. hospitals, including the USNS Comfort in Los Angeles and USNS Mercy in New York City, have immediate access to advance care plans including, possibly, updated details such as desires to be cared for “in place,” for a ventilator or other specific healthcare wishes.

“During this pandemic, people are frequently alone without an advocate in the room and potentially unable to speak for themselves, and hospitals are resisting paper documents from patients for risk of infection,” explained Scott Brown, co-founder and president of ADVault. “So now it is more critical than ever for people to have confidence our healthcare system cares enough about you to hear your voice, access your goals of care and talk to the people you’ve asked to speak for you. We are honored to work with eHealth Exchange to help more people have such confidence.”

Dallas-based ADVault is a global, person-generated health data company credited with inventing digital advance care planning in 2007. and MyDirectives MOBILE allow people to upload paper advance directives (e.g., Caring Conversations®, Five Wishes® and the Veterans Administration’s form 10-0137), digital advance care plans such as MIDEO® and the MyDirectives uADDTM, the new COVID-19 personal statements and portable medical orders such as POLST and MOLST forms. The service is entirely free to consumers. The platform is financially supported by providers and health insurers such as Humana and UnitedHealthcare who want to help their members have a voice in their care.

“Even before the current pandemic, we as a healthcare community understood that advance care plans are imperative to better serve people by understanding their wishes for care,” said Jay Nakashima, executive director of eHealth Exchange. “ADVault’s addition of personal COVID-19 statement functionality is a significant addition to the value that eHealth Exchange is bringing to our healthcare ecosystem. We thank ADVault and its integration partner Zen Healthcare IT for putting this collaboration on the fast-track so our participating hospitals and health information organizations can help more people during this intense global crisis.”

In normal circumstances, providers and caregivers use the eHealth Exchange to access patient information from outside their own facility to ensure a complete clinical picture and to make more informed decisions for better care. Advance care planning documents, including the COVID-19 statements that individuals are recording with their doctors, nurses and loved ones, on file with MyDirectives are now being pulled into electronic health records to empower caregivers with vital information to help guide clinical decision-making.

“Everyone at eHealth Exchange and at Zen moved quickly in recent weeks as the global health crisis caused leaders to realize the growing importance of advance care plans,” said Mike Munoz, ADVault’s director of product. “We are impressed with the entire team’s effort to focus on behalf of consumers and their goals of care.”


About ADVault, Inc.
Since 2007, Dallas, Texas-based ADVault, Inc., is the world’s leading all-digital advance care planning platform via the award-winning MyDirectives and MyDirectives MOBILE interfaces, now with consumer users in over 50 countries. MyDirectives lets people create, store, update and share the free MyDirectives digital advance care plan or upload any third-party advance directive (such as documents from Caring Conversations®Five Wishes®, the VA Form 10-0137 (U.S. Department of Veterans Affairs), advance care plan, COVID-19 personal statements or portable medical order. Additional information can be found at, or this TEDx Talk.

About the eHealth Exchange
The eHealth Exchange, a 501(c)3 non-profit, is among the oldest and largest health information networks in America and is most well-known as the principle way the federal government shares data between agencies and with the private sector. The eHealth Exchange network, which is working in 75 percent of all US hospitals, is leveraged by more than 30 electronic health record (EHR) technologies and 61 regional or state health information exchanges (HIEs). Four federal agencies (Centers for Medicaid and Medicare, Department of Defense, Department of Veteran Affairs, and Social Security Administration) participate in the network to share patient information with private sector partners as well as other agencies. In all, the eHealth Exchange supports secure exchange of the records of more than 120 million patients. / @ehealthexchange

About Zen Healthcare IT 
Zen Healthcare IT is an interoperability technology and consulting firm. Zen helps all stakeholders in healthcare – vendors, providers, payers, HIEs, and ACOs – simplify interoperability. Using technology tools and years of interface development and support experience, Zen’s solution architects and engineers design and build use-case driven solutions for health information exchange. The Zen team solves problems ranging from data acquisition, data normalization and aggregation, and data delivery challenges. Zen’s national client-base leverages Zen’s broad range of services, on-demand engineering, and disruptive Gemini Integration as a Service platform helps overcome interoperability obstacles and creates sustainable health information exchange infrastructures. Learn more at

MSNBC on the Front Lines

“People always ask me as an ER doctor, ‘What can I do to help you?’ One of the most important things you can do is have an advance care plan,” Dr. Elizabeth Clayborne tells MSNBC’s Alex Witt, “Go to to look at state specific plans, or an online platform like MyDirectives, because thinking about that ahead of time instead of when it’s an emergency is one of the most useful things that you can do for me as an ER provider.”

USA TODAY | ER doctor: Your end-of-life care plan can help save time and lives in amid coronavirus

Field hospital in New York City's Central Park on April 08, 2020.

Advance plans are especially vital now. To give just one example: A person who wants to die at home may free up an ICU bed for a coronavirus patient.

By Dr. Elizabeth P. Clayborne

As an emergency room physician, I’m used to working in a hectic environment. I have never experienced anything as heartbreaking and traumatic as the COVID-19 pandemic. It’s an intense and difficult time for everyone, especially patients and health care providers. Compounding that challenge is the increasingly common experience of doctors being forced to make impossible decisions for patients for whom we have no medical history and who did not plan their care in advance.

Physicians such as myself are becoming overwhelmed and the need to know patients’ advance care plans is more vital than ever. Scarce resources such as ventilators and ICU beds will become precious and it is essential that we reserve these treatments for patients who want them and can most benefit from their use.

Whether you are 18 or 80, advance care plans make it easier for doctors to provide care that honors the wishes of an individual if they are unable to speak for themselves. In the ER, we have minutes to make a decision that will dictate if a person might live on a machine or pass a natural death. I always make decisions based on what I think is best for the patient, but unless people have an advance care plan, that is exceedingly difficult. If I’m told about a patient’s wishes, not only does my work become more person-centered — it can also be quicker. As we handle massive influxes of patients amid dwindling yet crucial resources, time is everything.

‘Die Naturally and with Respect’

One of the most common dilemmas that families and medical professionals alike must navigate are DNR, or “Do Not Resuscitate” orders. Especially now, this ethical question is at the forefront of public discussion, as hospitals evaluate their DNR policies amid COVID-19.

I know patients and families are afraid to say that they don’t want to be put on life support, even if it means their quality of life may decrease, because they assume that they will receive no medical treatment. This falsehood is indicative of a troubling pattern. Too many people are not considering their health care decisions in advance, and as a result, are not being educated on what many of these terms and practices even mean.

I always tell people that “DNR” can mean to “Die Naturally and with Respect.” For some patients, they would rather have their pain and symptoms controlled and have a focus on the quality of their life rather than the quantity of days that they are alive. Others wish to be put on life support for a variety of reasons. It is simply essential that patients be given the space and resources to make an informed decision. If a person expresses in their advance care plan, for example, that they wish to be cared for at home, then that can help make an ICU bed available for a person who requires hospitalization.

For years, many physicians have asked our government, employers and health insurance providers to encourage everyone to create an advance care plan so we are able to understand patient’s wishes and can respect their decisions if they become critically ill. With or without a pandemic, having an advance care plan in place benefits both patients and providers. It allows patients to communicate their medical wishes to their families, doctors, nurses, and other caregivers and helps providers administer the desired care in a timely manner. As we’ve learned from global reporting on COVID-19, being able to treat patients efficiently is essential to reducing fatalities, maintaining lifesaving resources and preserving the effectiveness of our health care systems.Get the Opinion newsletter in your inbox.

Vital to have a plan amid global crisis

Everyone deserves the peace of mind of knowing their wishes will be respected, even and especially if they become incapacitated. In making an advance care plan, patients should consider some basic questions: (1) Who do you want to represent you if you can’t communicate during a health crisis? (2) What are your values and treatment goals? (3) What medical history and information do you want anyone who treats you to have? 

My highest aim as a physician is to provide person-centered care. I can’t do that unless my patients clearly articulate and communicate their wishes while they are able to do so. has online resources for advance care planning that are state specific, but it is very helpful to have an electronic record that can be kept up to date. For example, I use a free online platform Plans created online can be altered quickly and securely as needed and can be shared with family and medical providers, so everyone is on the same page.

It’s human nature to avoid subjects that remind us of our own mortality, especially in a time of heightened anxiety. But it shouldn’t take a global health crisis to illustrate the importance of discussing our goals of care and what our family should do if we become acutely ill. These conversations are difficult and raw, but pale in comparison to the grief that may come – and that I have seen materialize for too many families – when a loved one is in an emergency situation and they don’t know how to best advocate for them. 

As in every area of life, I encourage people to hope for the best outcome in a medical crisis and prepare for the worst. It is always considerate and responsible to have an advance care plan in place. In an international crisis — for patients, families, and medical personnel on the frontlines of the COVID-19 pandemic — it is indispensable.

Dr. Elizabeth P. Clayborne is an emergency medicine physician based outside of Washington, D.C. She has a master’s degree in bioethics. Follow her on Twitter: @DrElizPC

Read the op-ed on USA Today online here:

Cheddar News: On the Front Lines of the Coronavirus Pandemic

Dr. Elizabeth Clayborne of the University of Maryland’s Prince George’s Hospital Center talks to Cheddar News about fighting on the front lines of the coronavirus pandemic while being pregnant herself.

“I’d really like to emphasize that in addition to putting ourselves on the line we’re also being prepared for the storm of people that could come and overwhelm our facilities and when that surge arrives we’re often going to have to make important decisions about who to care for what scarce resources like beds and ventilators to use. So, I always emphasize the importance of people having an advance care plan and talking to their loved ones while they’re home to ensure they have an understanding of what you would want done in case you do become acutely ill,” said Dr. Clayborne. “And that’s specifically important so that doctors like me don’t have to be overwhelmed with having to make these difficult decisions if we do indeed become overwhelmed by the number of people that come at one time. So you can go to to fill out advance care plans that are state specific or you can use something like, which is an online platform does the same thing.”

Pregnant ER Doctor Treating Coronavirus Patients Urges People to Make a Care Plan

  • Dr. Elizabeth Clayborne, an ER physician at the University of Maryland Prince George’s Hospital Center, says anyone, even young people, can make an advance care plan

Dr. Elizabeth Clayborne is an ER physician at the University of Maryland Prince George’s Hospital Center, and offered her first-hand account of treating coronavirus patients.

“We’re very busy. We definitely in the last week have seen an increased number of acutely ill patients, people coming in, respiratory distress,” Clayborne said.

“Right now, we’re really bracing ourselves for the storm that we think is coming upon us. We’re currently seeing an increased number of COVID positive patients,” she said.

Clayborne is treating coronavirus patients amid a staff shortage and says she will continue to work for as long as she can.

“It’s definitely scary being a pregnant mother. I also have a young daughter, a 17-month-old, at home. So every time I come home I am taking a risk,” she said.

Clayborne said she wanted to share her perspective as a doctor on the front lines to urge people to make a plan for how they want to be treated if they become critically ill.

“I really wanted to bring some awareness to some important topics that haven’t been as well covered in the media, that are really being highlighted by this crisis, and that is advanced care planning and for people to start thinking about, what they would want done if they become acutely ill,” she said.

She says anyone, even young people, can make an advance care plan.

“Make sure it is clear and specific, you don’t want your family to be burdened trying to make decisions for you in a crisis,” Clayborne said.

To make a plan, go to to search online resources for advance care plans that are state-specific or go to