FOR HEALTH SYSTEMS
the infrastructure that closes the documentation gap.
anchor is being designed to help patients complete advance directives at home — before documentation gaps show up in the chart. The platform is intended to support retrieval of completed documents by authorized clinicians when it matters.
The problem you already know
Only 31%
of emergency physicians reported confidence they could locate ACP documentation in the EMR — yet 74% needed it at least once per week
Lakin et al., J Palliat Med 2016
Only 30%
of deaths in usual care had patient wishes known and followed — compared to 86% when advance care planning was completed
Detering et al., BMJ 2010, RCT
55%
of documented ACP discussions and 70% of updated treatment preferences were not easily accessible in the EHR
Walker et al., J Pain Symptom Manage 2018
Many health systems still depend on manually uploaded or scanned documents for advance care planning. Without a guided creation pathway, patients who never complete a directive can be hard to identify in routine workflows. anchor is designed to help close that upstream gap.
Five budget holders, five reasons to say yes
Billing
ACP conversations are billable under CPT 99497 and 99498 — yet many health systems leave that reimbursement on the table. anchor's documented workflow is being designed to support the clinical record billing teams need to capture it consistently.
Chief Medical Officer
Documented patient preferences can improve value-based quality scores and goal-concordant care. When directives are completed upstream, clinicians spend less time guessing and more time honoring what patients actually want.
Finance
Research in high-spending hospital referral regions shows treatment-limiting directives can reduce unwanted, costly end-of-life utilization (Nicholas et al., JAMA 2011). Modest completion gains at scale could produce meaningful savings relative to platform cost.
General Counsel
When patients arrive without documented wishes, liability exposure rises after the crisis — not before. anchor is being designed to help organizations document preferences proactively, reducing surrogate conflict and legal uncertainty when decisions matter most.
Equity / Population Health
Non-Hispanic White adults are nearly four times as likely to have an advance directive as Black or Hispanic adults (Koss & Hensley, Innovation in Aging 2020). anchor is being built to close a documented completion gap CMS and accreditation bodies are watching — mobile-first, plain language, and Spanish-language.
How anchor fits with health records
Near term: EHR-friendly workflows
Patients complete their directive and share the document through familiar patient-portal upload paths many health systems already use. This is designed to support existing chart-review workflows without requiring deep technical integration on day one.
Longer term: deeper EHR integration
Over time, anchor is building toward tighter connections with major electronic health record systems so completed directives can flow into the patient chart with less manual work — including healthcare agent and preference fields where supported.
WHERE ANCHOR WORKS TODAY
Supported jurisdictions
Anchor's virtual witnessed execution flow is designed for states that accept two-witness advance directives. Maryland and Florida, with additional states coming soon. Requirements vary by state and are subject to legal review.
Fully supported
State-specific legal forms and witnessed video execution.
- Maryland
- Florida
Coming soon
Selectable now; directives generated under Maryland law until full support launches.
- New York
- New Jersey
- Pennsylvania
- Virginia
- Texas
- California
Not supported
These states require both witnesses and notarization — outside Anchor's current model.
- North Carolina
- Missouri
Preparing for clinical validation
anchor is in early-stage conversations with potential clinical collaborators and advisors across emergency medicine, primary care, clinical informatics, and health law. We are exploring pilot settings with teams interested in measurable improvement in advance care planning documentation and retrieval. No active health system pilots are underway today.
“This could get us 80% of the way — rather than starting from the beginning.”
What a pilot would look like
1
A focused quality-improvement pilot in one clinical setting. We provide the platform. Health system partners provide the patient population and clinical oversight. Outcomes are shared for learning.
2
Completion and engagement data, stratified by demographics where appropriate — suitable for internal QI review or collaborative publication with partner teams.
3
Broader rollout informed by pilot results, with early health system partners as reference sites for regional growth.