Frequently Asked Questions about MyDirectives

We get asked a lot of questions about what we do and why we are doing it. Here are just a few of them:

Why Do People Need Emergency Critical and Advance Care Plans?

Unexpected emergency, critical or end-of-life medical situations can happen at any age, so all adults 18 and over, not just the sick or elderly, need an emergency, critical and advance care plan. You may know what kinds of medical treatments you want (or want to avoid) if you ever suffer a health emergency, but there may come a time when you are seriously injured or too ill to make and communicate your medical treatment goals, preferences and priorities. If that happens, your emergency, critical and advance care plan provides a record of your wishes so that your family, caregivers and doctors have a guide in making medical treatment decisions on your behalf that are consistent with your values, beliefs, and preferences. Having discussions about what treatments you would or would not choose and completing your emergency, critical and advance care plan before a crisis occurs can give peace of mind to you and your family. Having a digital version of your care plan, including clear video and audio messages to enhance the validity of your typed comments, can help reduce anguish, stress, conflict, and potential legal disputes associated with emergency, critical and end-of-life medical treatment decisions.

How Long does it take to complete?

The time can vary somewhat. It depends on how prepared you are and how many questions you decide to answer. Usually, it takes between 15 minutes and an hour. Some MyDirectives users take several days to complete their care plan because they want to think about the questions or talk to family members or their doctor.

Do I have to do this all at once?

No. MyDirectives lets you take your time. You can do as much or as little at a time as you like. There's no pressure - you can always go back and fill in missing information. If you do quit without finishing, you can resume at any time by clicking on the appropriate link on the My Home page and picking up where you left off.

What are the questions I’m asked in MyDirectives?

Questions in this section refer to medical treatments and procedures you might face sometime in the future. You're asked to think carefully about the things in your life and health that you value most, whether you would want palliative or hospice care, the situations in which you would or would not want doctors to attempt CPR, and whether you want to be an organ donor. Some of these questions may be difficult to answer, and you may need to come back to them later. Take your time. It's important to think these things through. This will help ensure that when the time comes, your medical treatment goals, preferences and priorities will be clear.

What are advance medical directives?

Advance medical directive is a general term for any document you use to give instructions on the medical treatments you would want or not want under particular conditions. You can also use an advance directive to choose someone to make medical treatment decisions for you if you can't make or communicate those decisions yourself. The two main types of advance directives in the United States are living wills and medical powers of attorney. You can change your advance medical directives at any time and even revoke them completely. Your current wishes, provided that you are able to express them and understand the consequences of treatment decisions, take priority over written or recorded expressions of your medical treatment goals. That includes both advance medical directives and your emergency, critical and advance care plan created using MyDirectives.

What is a living will?

A living will is a type of advance medical directive in which you state your wishes about medical treatment should you be at the end of life and unable to make and communicate your choices, or should you be determined by a court to be incompetent. A living will may also be called a directive to physicians and family, a healthcare declaration, a medical directive, or an advance decision. Remember, under the laws of most countries and states, a living will only takes effect when you are determined by a physician to be terminally or irreversibly ill (as a result of injury or disease, and as defined in law) and you lack decision-making capacity. As long as a terminally or irreversibly ill patient is able to make decisions and communicate with the physician, the living will is not active. In contrast, MyDirectives' Universal Advance Digital Directive (uADD)™ includes medical treatment preferences usually included in living wills, but it is a higher quality document that doctors and nurses can access and consider any time you suffer a health emergency and are unable to communicate with family, caregivers or medical personnel.

What is a medical power of attorney?

A medical power of attorney is a form of advance medical directive that you use to appoint someone else to make decisions about your medical treatment if you are unable to make and communicate medical treatment decisions yourself, or if you are determined by a court to be incompetent. This type of advance medical directive may also be called a healthcare proxy, a durable power of attorney for healthcare, or an appointment of a healthcare agent. The person appointed may be called a healthcare agent, surrogate, attorney-in-fact, or proxy. The Universal Advance Digital Directive (uADD)™ includes the designation of a primary healthcare agent and up to two alternates, but it is better than a medical power of attorney because it can be located, retrieved, accessed, and considered any time you suffer a health emergency and are unable to communicate with family, caregivers or medical personnel.

What is the difference between and advance medical directive and a living will?

An advance medical directive is any document that allows you to give instructions about future medical treatment preferences in case you become unable to make decisions on your own behalf or can't communicate your wishes, or if a court determines that you are incompetent. A living will is just one type of advance medical directive that allows you to document your wishes about medical treatment. Another type of advance medical directive is a medical power of attorney that allows you to appoint someone else to make decisions about your medical treatment for you. "Do-not-resuscitate" or "do-not-attempt-resuscitation" orders (orders signed by a doctor instructing medical treatment providers not to attempt CPR in the event of cardiac arrest or respiratory arrest) are another type of advance medical directives.

How is the uADD different from an advance medical directive or a living will?

The term "advance medical directive" is a generic term that usually refers to just one kind of directive - a living will, a medical power of attorney, or a "do-not-attempt-resuscitation" order. The Universal Advance Digital Directive (uADD)™ that you create using MyDirectives incorporates all of the elements of a living will and a medical power of attorney, but it does much more than that. The uADD also includes an expression of your preferences on CPR that is similar to the instructions included in DNR/DNAR orders, as well as organ donation and autopsy preferences. The uADD also includes a My Thoughts section that lets you describe non-medical requests about more personal aspects of your care and comfort, and contact information for your doctors, insurance providers, family and friends that medical treatment providers may need to contact if there is a medical emergency. Finally, the uADD lets you to keep your answers simple or make them as detailed as you like by using open-ended text boxes or uploading audio and video files. All of these things combine to make the uADD a much higher quality document than a simple living will or any other standalone advance medical directive.

The most important difference between a uADD and an advance directive the process used to create it. First, MyDirectives is the only service that guides you through the process of creating a high-quality emergency, critical and advance care plan using a flexible process that lets you give detailed answers and accurately express your medical treatment goals, preferences and priorities. MyDirectives informs and educates you along the way, and we built logic into our system that will lower your chances of providing ambiguous or conflicting answers, but MyDirectives will never "lead" you or pressure you into choosing (or foregoing) particular medical treatments.

The uADD is also different from an advance directive or a living will because it is created using a true digital healthcare platform. MyDirectives embraces modern technology and uses it to securely store your completed, signed uADD "in the cloud," and we work closely with healthcare providers, payers, and electronic medical record vendors to make your uADD available for retrieval 24 hours a day, seven days a week, anywhere in the world.

Most importantly, MyDirectives understands that emergency, critical and advance care planning isn't just about a legal form with signatures, it is about conversations. Research shows that the only truly reliable strategy to ensure your medical treatment goals, preferences and priorities are considered if you ever suffer a health emergency and can't communicate is to discuss your values and wishes with your family, caregivers and healthcare providers ahead of time, before a crisis occurs. So, we make it easy for you to safely and securely share your uADD with whoever you want, we communicate with your chosen healthcare agents on your behalf, and we provide conversation starters and discussion guides to help facilitate those conversations.

What is MyDirectives?

MyDirectives is a digital platform that lets you create, store, update, retrieve and share an emergency, critical and advance care plan using a form that we call the Universal Advance Digital Directive (uADD)™. MyDirectives MOBILE is a free Apple Store app that you can use to designate your healthcare agents, locate and share your uADD and record your preferences on organ donation. Both are designed to give you confidence your voice can heard if you ever suffer a health emergency and cannot communicate with family, caregivers, or medical personnel.

MyDirectives features help you create one clear, well-thought-out document. If you don't understand a particular question and want to discuss it with your doctor, click "Conversation Starters" for a list of questions to discuss with your family, healthcare agent or doctor.

What information does MyDirectives send to hospitals?

Until you've digitally signed your emergency, critical and advance care plan, no information about you is available to anyone, including a hospital. Once you have completed the electronic signature process, your uADD, HIPAA Authorization Form, and Summary for Physicians can be viewed and downloaded by an authorized medical facility. Nobody can change any information in the file except you. Medical facilities can search and print your records either because you're being admitted to a facility and you ask them to, or because you are determined to be incompetent or can't make and communicate your wishes, and the admitting staff person, nurse, or doctor searches the MyDirectives database for your uADD.

Is the completed Universal Advance Digital Directive a legal document?

The completed uADD is not focused on trying to be a legal document like a "living will" or an "advance directive." Since you can make your answers as detailed or general as you want, update them over time, and add video messages, audio files and other attachments to clearly express your preferences and goals, we believe it is better. MyDirectives leads you through a process that helps you create a higher quality document that doctors and nurses will actually be able to find and use. And remember, in most places, even advance directives are not "legally binding," they are just "legally recognized." Doctors can always refuse to comply with your wishes if they have an objection of conscience or consider your wishes medically inappropriate.

Does this information become part of my medical record? If so, how?

Yes. Medical facilities can search and print your records if you're being admitted to a facility and you ask them to, or if you can't communicate, the admitting staff person, nurse, or doctor can go to the MyDirectives database and look for your uADD. For hospitals that use paper medical records, your printed forms usually will be attached to your medical file. MyDirectives is working with hospitals with electronic medical records to ensure that they will eventually be able to attach your uADD to your digital medical file.

Can I/should I print this for my records?

You can print your uADD anytime. Just click "Print My uADD™" on the My Home page. But printing is not always necessary or even the best choice. We encourage you to access your uADD online when you want to look at it or make changes. That way, the most up-to-date version also will be in our system. Hospitals and doctors can also access your uADD by searching for it online.

•Sending a secure link to view your uADD is safer and ensures that your healthcare providers will see the latest version. Your digital records are safe, secure, and ready to be downloaded anytime you need them, anywhere in the world.

If you choose to print, treat your uADD as you would other important paperwork.

How is my information stored?

Your information is stored securely online in a partially encrypted database - it has a code that makes it difficult for anyone to read. To ensure your privacy, all communication between you and MyDirectives is protected that same way. Only you and those you authorize will be able to see your emergency, critical and advance care plan.

Will MyDirectives sell or share any of my information?

NO. MyDirectives won't share your data in any form in which you or your answers could be personally identified without your permission. The whole point of having an emergency, critical and advance care plan is to share your medical treatment goals, preferences and priorities with family, caregivers and healthcare providers when there's a medical emergency. When you sign your Universal Advance Digital Directive (uADD)™ using MyDirectives, you authorize only approved healthcare providers to search and retrieve your records. Insurance companies won't have access to your answers unless you give them access.

Is MyDirective really free?

YES, you can use MyDirectives for free to create, store, update, share and retrieve your emergency, critical and advance care plan anywhere at any time! We want you to live with confidence you will have a voice in your own care if you ever have an emergency and you can’t communicate with your doctors. We get paid by health insurance plans, healthcare providers, government agencies, and healthcare information technology vendors that believe finding and using high-quality advance care plans will help doctors treat you better.

Are there hidden costs?

No, there are no hidden costs to you. ADVault gets paid by private health insurance plans, healthcare providers, health information exchanges, accountable care organizations, health ministries, other government agencies, and healthcare information technology vendors that want to empower consumers and patients by making sure that they have high-quality advance care plans, and that those care plans are available at the right time and place, whenever they are needed. Again, our service is free to you as the enrolled.

Is what I enter in MyDirectives legally binding in all jurisdictions?

Most people believe that advance medical directives and similar paper forms described in laws and regulations of various countries and states are "legally binding" as long as they are signed and witnessed (or notarized) correctly, so doctors have to follow them. Similarly, they want to make sure that their Universal Advance Digital Directive (uADD)™ created using MyDirectives is "legally binding." At least in the United States, however, the American Bar Association has pointed out that advance directives are not legally binding, they are legally recognized - and you need to understand the difference. Advance directives give healthcare providers legal protection if they choose to follow your instructions, but doctors in most jurisdictions are allowed to refuse to comply with your wishes if they have an objection of conscience or believe your treatment choices are medically inappropriate. In fact, the only reliable strategy is to discuss your medical treatment goals, preferences and priorities with your family, caregivers and doctors before a crisis occurs so that everyone understands what you want if you ever suffer a health crisis and can't communicate. That is why MyDirectives places such importance on making those conversations easier and more effective for our users to have and to document. Whether you use a legalistic, paper-based form or MyDirectives' interactive process to record your wishes, the resulting document is just another tool that doctors can use when deciding what medical treatments to perform. Of course, the doctors first have to find them. MyDirectives is unique in that we help you create a higher quality document - a document that is less likely to include confusing, conflicting answers - and we help you share your uADD and discuss your wishes with anyone you want. Then, we do our best to make sure that your uADD can actually be found by healthcare providers if you can’t share it with them yourself.

What document does MyDirectives use?

MyDirectives uses an emergency, critical and advance care plan document called the Universal Advance Digital Directive™, or "uADD." The uADD™ contains elements that a person would normally see in traditional, paper-based advance directives like living wills, medical powers of attorney, and do-not-attempt-resuscitation forms, but it also includes MyDirectives users' preferences relating to things like organ donation and autopsy.

In addition to your medical treatment goals, preferences and priorities and the designation of healthcare agents, the uADD includes a section called My Thoughts that's designed to help improve the patient, caregiver and healthcare provider experience in an emergency, critical, advanced illness, or end-of-life medical situation.

What company is behind MyDirectives?

MyDirectives is offered free to individuals by Dallas, Texas-based ADVault, Inc., a privately held U.S. corporation dedicated to ensuring that people can live with confidence they can have a voice in their healthcare, especially if they suffer a medical emergency and can’t communicate. ADVault is a for-profit company with a "not-just-for-profit" philosophy.

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