Advance Care Document Custodian

Advance care documents let individuals make choices about their future medical treatment in the event that they are cognitively impaired or otherwise unable to make their preferences known. Currently, a completed directive is kept in a safe place with a designated custodian controlling access to it.

The advance care document custodian form provides information about the custodian of the individual’s advance care directive. Such documents do not contain the advance care directive itself.

Advance care documents in the Australian context

An advance care document is a statement by a competent person expressing decisions about his or her future healthcare, should he or she become incapable of participating in medical treatment decisions. Each Australian state and territory has their own advance care directive (or advance health directive) form.

The My Health Record system will provide a link to access the custodian details of an individual’s advance care document. The individual or their authorised representative will enter the advance care document custodian information via the Consumer Portal in the My Health Record system.

The advance care document will not be stored in the current version of My Health Record; however, future versions of the system may include electronically stored directives.

Context in digital health

There are a number of key business flows that occur within digital health in Australia, as outlined in Figure 1 below.

Figure 1: Advance Care Document Custodian high-level overview

These flows are described below:

1. The consumer enters the details of the custodian of their advance care document through the Consumer Portal.
2. The Consumer Portal uploads the advance care document custodian to the consumer’s My Health Record.
3.  A clinician may access the advance care document custodian via the consumer’s My Health Record provided they have relevant access.