Frequently Asked Questions
- Why use Advanced Directives Registry?
- What are the advantages of using the registry to health care providers?
- Can my organization store existing directives or do you just store newly created ones?
- What does a provider have to do to join the registry?
- What if my patients want only one provider to have access to their information?
- What if I have a problem?
- Why does ADR do annual reviews?
- How does my family use this?
- I have homes in more than one state. What do I do?
- Is ADR’s data safe?
- What safeguards to registrants’ privacy does the Registry have in place?
- Is the Registry HIPAA compliant?
- Does ADR’s system work with our hospital’s electronic health records?
- How do providers know to access the ADR?
The Advance Directives Registry is a service that gives you the power to safeguard your end of life wishes. Many people have taken the time to get advance directive documents only to end up in a situation where they were incapacitated and their documents were not accessible. This advance health care directive registry solves that problem by offering a document storage service that is more practical than a shoe box.
Health care providers are required by federal law to inquire of patients if they have an advanced directive for health care and if they do, to include that document in the patient’s medical record. Furthermore, the provider is required to provide information about advance directives to the patient and the community. Health care providers have had a difficult time managing advance directives at their institutions. Filing, storing, retrieving, updating and trying to determine if an old document is still valid, are among the problems confronting providers.
Advance Directives Registry (ADR) provides an easy, turn-key, solution to these problems. ADR will store these documents in our secure data center. The subscribing provider’s staff can easily access ADR through their information system without additional authentication. This access is available to all locations that are part of the provider’s system including doctor’s offices. Documents can be retrieved, 24/7, using the patient’s registration number, name and date of birth, social security number or driver’s license number. Patients are contacted annually and encouraged to update their documents with any changes. The most current document is available to the provider. However, all previous documents are maintained in an inactive data store and can be retrieved by ADR or the registrant. The registrant’s record at ADR includes emergency contact information which is also kept current by the registrant. Additionally, ADR supports the provider’s community information compliance with materials explaining advance directives and their advantages to the registrant.
ADR will also provide each member provider with reports detailing their compliance with federal law, eliminating additional record keeping for them.
ADR can store and index all of your existing advance directive records and make them available on the registry. Providers may upload scans, photographs and PDFs to our system. These may be sent to us as an attachment to an email, or in physical media such as CD’s. Documents may also be transmitted through subscribing HIEs. These documents by their very nature cannot be altered but when a patient wants to update their document they will be able to create a new electronic document to replace it at no charge.
Providers are able to join the registry by documenting their credentials and paying their annual membership fee. This will give them 24/7 access to the registry through the internet, VPNs and participating HIEs. Member providers are the only organization who can upload documents to the registry or retrieve documents immediately. All other healthcare providers can access the registry by internet, mail or phone. And once their credentials have been established they will have access to the specific record they are requesting. If their credentials cannot be established, they will be told whether or not a record exists and they will be given the emergency contact information for the patient.
Providers that are concerned about releasing information to others can set up their own exclusive directory. Documents stored in this exclusive directory will only be available to that provider. If another provider searches the directory for a patient who is in an exclusive directory they will be given the contact information of the provider who is in control of that patient’s record.
The registry also has a help desk that provides customer support in case you have questions or issues regarding sign up and registration. Did we mention that signing up and registering is easy? An account with the Advance Directives Registry will give you peace of mind as you will always know that your end of life wishes are secure.
Because life situations change, advanced directives can cease to provide accurate information to providers as well as failing to truly represent the wishes of the patient. To overcome this problem ADR contacts all patients who have registered documents in the registry on an annual basis to require them to review their records to assure the accuracy of the records.
From within the Advance Directives Registry you can give your Friends And Family access to view documents that you have stored. They will be provided with a registration number for your account and the PIN that you selected during registration. If you wish to restrict access to your account at any time, simply change your PIN.
The registry is national, allowing you to upload several types of advance directives from all 50 states. It was made to be as simple as possible so that people with all levels of familiarity with internet technology would be able to sign up and register their documents. Once you sign up and register you will be sent a registry ID that contains your registration number, emergency contacts and primary care physician information. The registry makes it simple for designated agents, providers and family members to access your wishes with copies of your registry ID card.
ADR’s data is stored on secured servers in a high security data storage facility. The facility is climate controlled and the system is protected from power failure by multiple power sources. Daily backups are stored both onsite and off. If the system is down for any reason, the registry is still available by email, phone and fax.
The Registry is very sensitive to the privacy of our registrants and to the confidentiality of the information and the documents they register with us. We are committed to maintaining this privacy and confidentiality. The Registry utilizes 128 bit encryption when transmitting documents over the Internet, and access to the Registry’s system is password protected.
Once the document is transmitted to the health care provider, it is immediately placed in the confidential medical record. Law protects the privacy of medical records. Our agreement with each registrant clearly states “Registry is not authorized to share my personal information with parties other than health care providers.” The Registry does not share or sell personal information to any outside parties.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated regulations that govern privacy, security, and administrative simplification standards for health care information. The Registry is not a covered entity under the HIPAA regulations. The Registry voluntarily complies with HIPAA regulations, and will enter into Business Associate/Chain of Trust Agreements with member Health Care Providers. The Registration Agreement signed by each registrant of ADR authorizes the Registry to provide a copy of the registrant’s advance directive to health care providers. The Agreement also restricts the Registry from providing advance directives or personal information to parties other than health care providers. Registry staff are required to sign a confidentiality agreement. In addition, the Registry maintains a log of date, time, where and to whom each document is sent. This information is available to member health care providers through a custom report feature on the health care provider’s web page. These reports are a great way to document your facility’s compliance with HIPAA, and to comply with state and federal regulations regarding advance directives.
ADR’s system is able to receive your patients advance directives directly from their EHR. Most hospitals find it difficult to manage advance directives in the EHR because it is difficult to separate from the record and there is no way to know if the advance directive on file is the most recent version. The employees of member hospitals have direct access to their patients advance directives through the registry. Since the patients have the opportunity to regularly update their directive the hospital can be assured that they have the most recent document. Since it has already been separated from the EHR there is no problem with portability of the document in either hardcopy or electronic form.
ADR provides each patient with a wallet card with their registration number. However, providers do not need the registration number to access their record, only the patient’s name and date of birth, their social security number or their driver’s license number. The registration number along with as secret PIN allows access when authorized friends or family are contacted. The file available to the provider is a read only file.