Systematic identification of metastatic population subsets for advance care planning (ACP) discussions: A scalable approach using electronic health record (EHR) technology.

243 Background: Comprehensive cancer care embraces the concept of having timely discussions with patients about end of life care preferences regarding treatment interventions. Physicians and healthcare teams are frequently challenged with identifying patients who are clinically appropriate for these discussions and subsequent management of ACP work within the context of clinic resource capacity. A data extraction process is needed to systematically identify cancer population subsets for ACP based on clinical data elements maintained within an EHR database. Methods: Seven cancer center sites of service participated in a 90-day pilot study for delivering ACP services to discrete patient populations who it was believed would most benefit from ACP. Electronic methodology was developed and tested through the pilot process to systematically identify those patients having documented evidence of designated clinical criteria, including metastatic disease status. Metastatic status was determined using five clinical...