With patient video testimonials, we can now hear from patients when they are critically ill and receive their guidance rather than providers guessing after reviewing a form that may or may not have been completed correctly. Resuscitations are complex, and we need to know what to do in the first seconds to 15 minutes—paper forms do not do this well. We will still need POLST and LWs, but we also need to hear from the patients, and with emerging technologies, we need to be able to do this in a safe and cost-effective manner.

In conclusion, we have a safety problem with documents, and TRIAD VIII presents an opportunity to do better. When appropriate, we have to rethink the concept of “treat first, ask questions later.” We need to embrace both LWs and POLST and be sure we set quality standards for their completion and understanding. We further need to investigate technologies to allow us to hear from patients to accurately guide their care.

Dr. Mirarchi is medical director in the department of emergency medicine at UPMC Hamot and chairman of UPMC Hamot Physician Network in Erie, Pennsylvania.

Dr. Aberger is core faculty, emergency medicine/palliative medicine, for St. Joseph’s Regional Medical Center in Paterson, New Jersey. She is also chair of ACEP’s Palliative Medicine Section.