1. Enthusiastic Responses to
Advance Care Planning with
Video Decision Support Tools
Michael Paasche-Orlow, MD, MA, MPH
Associate Professor of Medicine
Boston University School of Medicine

2. Goals
 Share summary observations
 High level of acceptance of video tools

3. The Video Images of Disease for Ethical
Outcomes (VIDEO) Consortium
 Led by Dr. Angelo Volandes
 Completed 13 clinical studies
 7 ongoing studies

4. www.acpdecisions.org
 Non-Profit Foundation
 Video Decision Support Tools
 Empower patients
 Improve decision-making
 18 scenarios to promote
 Goals of Care
 CPR
 >50 health care entities

5. Extensively vetted and tested
 Short
 Plain language
 Cinema vérité
 Seen together with a provider

6. Summary Observation #1
 Significantly improve decision-making
 Knowledge
 Decision certainty
 Stability of preferences

7. Summary Observation #2
 Significantly influence preferences
 Set limits

8. Summary Observation #3
 Very well accepted by patients
 Helpful
 Comfortable
 Recommend

9. 90%
“Comfortable”
90%
“Helpful”
100%
“Recommend”
7 minute GOC video for patients with advanced cancer
[Control 78% LP or Limited Care vs. Video 4% Limited Care]

10. 93%
“Comfortable”
90%
“Helpful”
97%
“Recommend”
3 minute CPR video for patients with advanced cancer
[Control 48% wanted CPR vs. Video 20% wanted CPR]

11. 85%
“Comfortable”
88%
“Helpful”
95%
“Recommend”
2 minute GOC video about advanced dementia
[Control 30% LP or Limited vs. Video 12% LP or Limited]

12. 94%
“Comfortable”
88%
“Helpful”
88%
“Recommend”
5 minute generic GOC video studied at SNF
[Control 42% LP or Limited vs. Video 20% LP or Limited]

13. Additional Observations
 Relieved to talk
 Felt like a real unmet need
 Poor communication w/ providers  fear
 Stuck on machines
 Poor communication w/ surrogates  fear
 Burden

14. Conclusions
 People are ready for engagement in ACP
 Current decision-making frequently poor
 Can be markedly improved

15. Questions please
 mpo@acpdecisions.org
 www.acpdecisions.org