How ADVault Inserts Patients’ Values into Their Care

I recently had the pleasure of sitting down and getting to know Scott Brown, president and co-founder of ADVault. ADVault’s mission aligns with ours, which is to help innovative healthcare organizations make patients healthier, happier, and more engaged—while managing costs. Here is what Scott had to say:

What drove you to leave your successful career in business law and found a healthcare technology company?

Great question! My grandmother, who grew up during the Oklahoma dust bowl, spent the last 30 years of her life in a nursing home battling illness, dementia, and all of the hardships that come with old age and chronic conditions. My mother told me that my grandmother had a Do-Not-Resuscitate Order (DNR), but the situation put our family through a lot of stress because not everyone agreed with her DNR decision and clinicians refused to follow through.

My mother has Multiple Sclerosis and could eventually follow a similar trajectory. Given these personal experiences, my wife and I thought that there must be a better way. Advance directives as paper documents are inaccessible and difficult to uniformly understand and follow. In 2007, we started searching for a better solution for my mother and found there really wasn’t one. Finding no good solution, we decided to start a company and build our own. I approached my friend and business colleague Jeff Zucker for advice on strategy and direction. Jeff was dealing with similar family situations, immediately understood the need, and joined the company.

One of the other driving forces behind this solution was the Terri Schiavo case. In 2005, Terri collapsed unexpectedly. She was only 27 years old and was kept alive, in a vegetative state, for 17 years. During that time, there were 13 lawsuits – three of which went all the way to the Supreme Court. This tore the families apart because Terri was not able to communicate her end-of-life preferences. I remember my wife Geraldine saying, “The most important voice in the room isn’t there. It's hers.” 

Tell me about the evolution of ADVault from creation to current day:

The original concept was an “online vault” where individuals could create an account and upload, store and share advance medical directives, medical and pharmaceutical records, and other wills, trusts and estate documents, and where healthcare providers, government officials and legal professionals could securely access and retrieve the documents from anywhere in the world via the Internet if and when needed. As we dug in, though, we quickly realized that the status quo was “junk in, junk out.” We wanted to fix this.

From day one we knew that we wanted to make our services free to veterans and active military. These individuals are routinely catastrophically wounded and have no one around to communicate their preferences for their care. This desire influenced our decision to make MyDirectives free to all consumers. We set out to create a ubiquitous, interoperable advance care planning system that is accessible 24/7 from anywhere in the world.

In 2012, after five full years of research – speaking with doctors, lawyers, ethicists, healthcare informatics specialists, and technology personnel – we went live with MyDirectives.com. At about the same time, I left my law firm to join Jeff and our team and focus on the company full time. We were mistaken in thinking that this was going to be an easy, common-sense thing. We never realized that we would still be expanding and socializing the idea of advance care planning 13 years later.

What is the mission of ADVault?

Our mission at ADVault is to help people live better lives, with confidence that they have a voice in their healthcare.

Our first platform-as-a-service, MyDirectives, is the most widely used consumer-facing platform that empowers people to create a digital advance care plan or upload a paper advance directive or portable medical order like POLST and MOLST forms. We want to evangelize the idea that advance care planning isn't just for people nearing their end-of-life. Advance care planning is self-care, for everybody over the age of 18. For almost 50 years advance directives were purely a means to say what life-sustaining treatments you didn’t want, but giving patients a voice in their care should really be about how you want to live . For example, expecting mothers and fathers should be able to share their priorities in a birth plan, and people with chronic illnesses should be able to share nutrition and physical therapy preferences with their care team.

We aim to take the stigma out of advance directives and advance care planning. All of the thought leaders in healthcare say that advance care planning is not just about death and dying, it’s an okay thing to do, it is a responsible thing to do. In your mind, frame advance care planning as a gift for yourself and for the people you care about. That way, if something ever happens – even a car accident where you’re expected to recover but can’t communicate for awhile – everyone can participate in the care process knowing that they are honoring your goals and preferences as best they can.

What are the most exciting things you are working on at ADVault?

We’re working on a lot of exciting projects, including integrations with several HIE customers. Three really exciting things that we are rolling out are:

  1. New content and functionality with a focus on education. We have an exclusive relationship with The Society for Post-Acute and Long-Term Care Medicine – AMDA – where we’re using AMDA tool kits and clinical guidelines to help providers have high-quality discussions about advance care planning.
  2. Our facilitated advance care planning solution that gives clinicians two paths to help their patients with advance care planning and then get reimbursed for having these conversations. The solution is web-based and doesn’t require any EHR integration.
  3. Integration with both payer and provider member and patient portals, giving millions of people easier, direct access to MyDirectives.