End-of-life care is clinically, ethically and operationally challenging because palliative and medical professionals work with symptom management, prognostic uncertainty and family involvement under time constraints. Health information technology provides structure in those moments. When well done, it aligns documented preferences with bedside care, reducing ambiguity and supporting informed consent in routine and crisis settings.
Advance Directives Integrated Into the Electronic Health Record (EHR)
Health IT supports clinical practice and supplies the infrastructure for serious illness decision-making. The presence and use of health care AI are common. In an American Medical Association survey, 66% of physicians reported using health care AI in 2024. That degree of digital integration could suggest receptiveness to embedding advance care planning tools into clinical workflows.
For advance directives to be effective, timely access to these documents is necessary, along with the capacity to act upon them. Entering code status, health care proxy and provider orders for life-sustaining treatment (POLST) information into structured fields in EHRs can reduce ambiguity during fast-paced transitions in care. By structuring documentation, clinical decision support can access preferences during order entry and care escalation.
Interoperability — the ability to share and use health information across systems — may help resolve these problems. For example, advance directives shared across health information exchanges and available in the emergency department can help avoid duplication of effort and misaligned intentions.
Financial Clarity for Complex Families
Medical professionals face the challenges of blended families, estranged relatives and multiple candidate surrogates. Sixty-two percent of people under 55 have at least one stepkin relationship, which can muddy the waters about who’s in charge of health care and end-of-life decisions, as well as who is responsible for medical costs. Health IT systems that incorporate confirmation and conspicuous displays of the legally designated health care proxy may reduce conflict during emotionally intense moments.
Trusts and other estate-planning tools can also provide added protection for blended families. Having a record with up-to-date fiduciary and health care proxy roles benefits the patients, family and the institute serving them. When scanned legal documents are available in the EHR and the proxy fields are coded, surrogate authority may be clearer.
Shared Decision-Making (SDM) Tools at the Bedside
SDM is an established process of combining clinical knowledge and patient values to ease informed consent. Its tools could display ranges of prognoses or the burdens and benefits of treatment in ways that preserve finer clinical subtleties.
According to the Office of the National Coordinator for Health Information Technology’s latest report, 70% of non-federal acute care hospitals were able to send, receive, find and integrate electronic health information. Such interoperability provides the infrastructure for SDM modules to be integrated into clinical workflows and to follow patients across care settings.
Effective platforms typically include:
- Prognostic calculators: Evidence-based algorithms predicting survival or functional outcomes
- Values clarification prompts: Questions about the relative importance of comfort, preservation of cognition or longevity
- Automated documentation templates: Discrete fields to record goals-of-care conversations
For example, if clinicians enter evolving goals in structured formats, teams use them to interpret preferences regardless of clinical status.
Communication Across Care Settings
End-of-life care often spans multiple settings — including acute hospitals, skilled nursing facilities and home hospice — leading to reduced continuity of care and an increased risk of conflicting medical interventions. Since unnecessary medical tests and treatments cost billions of dollars a year, access to directives can prevent wasteful spending.
Regular use of secure messaging, telehealth visits and standardization of discharge documents helps hospice providers avoid giving conflicting recommendations. Inpatient symptom management plans and code status documentation support integrated discharge summaries and reduce ambiguities during readmissions. Better data architecture can improve operations in serious illness care coordination.
Ethical Guardrails
Technology increases decision-making and risk. Advanced teams know that governance must be explicit. Consent management should be transparent, with audit logs that show who accessed advance directives and POLST forms. Role-based security protects sensitive information while ensuring appropriate clinical access.
Providers should carefully evaluate embedded prognostic algorithms for data sources, validation cohorts and limitations and regularly assess for bias to ensure equitable decision support. The design of order-entry interfaces should prominently display code status and minimize alert fatigue. Visible preference systems help prevent clashes in care.
Improved End-of-Life Medical Decisions Aided by Compassion
Health IT can surface preferences, structure documentation and reduce conflict. It cannot experience fear, grief or hope. Balancing the integrity of evidence alongside humanity is a core skill all health care providers must develop. A positive and respectful balance is possible, which honors the clinical data alongside the dignity of the dying person.
Leaders should ease and model systems that support this balance and provide the human empathy that technology cannot. Technological advances are driving the future of medicine, but computers can never replace human emotions and experience.
