Improving Advanced Care Planning with Video w/ MIDEO CEO Dr. Ferdinando Mirarchi

Many patients want to have a say in their medical care, especially when it comes to end-of-life decisions.

Despite this, only a third of U.S. adults have completed any form of advance care directive.

Even for those who do plan ahead, traditional paper-based advance directives often face challenges like misinterpretation or even being ignored altogether.

Could video-recorded directives be the answer?

In this episode of HealthBiz Briefs, MIDEO CEO Dr. Ferdinando Mirarchi sheds light on the limitations of standard advance care directives and explains why video-based solutions might deliver better results, offering greater clarity and ensuring patients’ wishes are honored.

This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/caretalk and get on your way to being your best self.

As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.

🎙️⚕️ABOUT CARETALK
CareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy.

🎙️⚕️ ABOUT FERDINANDO MIRARCHI
Ferdinando Mirarchi, D.O, is the CEO and Chief Medical Officer of USACS MIDEO, LLC, and recently appointed Chairman of the National Palliative Care Committee for USACS. As the Principal Investigator of the TRIAD Research Series (The Realistic Interpretation of Advance Directives), Dr. Mirarchi has uncovered a global patient safety risk stemming from confusion around living wills, DNR, and POLST orders. His research, featured in outlets like The New York Times and The Washington Post, led to the creation of MIDEO (My Informed Decision on VidEO), an innovative, evidence-based video advance directive designed to enhance patient safety by clarifying medical orders and making them instantly accessible.

🎙️⚕️ ABOUT MIDEO
MIDEO is a video-based advance care planning platform that ensures patient healthcare wishes are clearly communicated when patients cannot express them themselves. By translating patient directives into medical and legal terms, MIDEO makes them easily accessible to medical professionals through a QR code. This innovative approach enhances patient care and reduces costs by providing clarity on critical and end-of-life healthcare preferences. MIDEO offers services tailored for patients, families, health plans, and clinicians, emphasizing the importance of understanding and honoring individual healthcare choices.

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Transcript

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Many patients want control over end-of-life care decisions or just decisions for when they get very sick. And it can be a blessing for loved ones who otherwise have to make tough decisions in a tense environment. But traditional advanced directives are often ignored and can even backfire. Can technology change that equation for the better? I want to take the chance to thank my family for making a big effort to get together for Thanksgiving and especially those who are coming from thousands of miles away. It's going to be great to see everyone and especially together in person to say happy birthday to my dad. This month, November is all about gratitude and along with my family, there's someone else we don't thank enough and that's ourselves. So it's sometimes hard to remind ourselves that we're trying to make the best sense of everything. And in this crazy world, that isn't easy. So here's a reminder to send some thanks to the people in your life, including yourself. BetterHelp offers entirely online therapy that's designed to be convenient, flexible, and tailored to fit your schedule. Just fill out a brief questionnaire to get matched with a licensed therapist and switch therapists at any time for no additional charge. It's helpful for learning positive coping skills and how to set boundaries. It empowers you to be the best version of yourself. So whether you're dealing with stress, anxiety, or seeking personal growth, BetterHelp connects you with licensed therapists who can support you on your mental health journey. Let the gratitude flow with BetterHelp. Visit betterhelp.com slash care talk to get 10 % off your first month. That's betterhelp, H-E-L-P dot com slash care talk. Welcome to Health Biz Briefs. I'm David Williams, president of Health Business Group here with Dr. Fernando Mirarchi, CEO of Midio. The company helps patients record advanced care directive plans on video. Welcome Dr. Maracci. Hi, thank you for having me. Well, what is an advance directive and what is it supposed to accomplish anyway? So, advance directives themselves and this is going to sound like a mundane kind of answer. It's basically a paper-based document. It's a legal document and it's supposed to give you a patient a voice in your care to either accept or decline life-saving conditions or life-saving treatments when you are in a terminal condition or persistent vegetative state. Well, that is a simple answer, but also one that I think calls into question about the theory versus the practice. And I wonder, what are the limitations of these traditional paper-based directives? Great question. So limitations-wise, one, they're paper, right? We're in the 21st century, and we're still dealing with paper-based documents and so on. Two is portability. So these are 8 and 1 by 11 page documents, there's more than one page to them and so on and people would have to carry them wherever they go. So if you were going to bring it with you and people don't typically carry them, right, because it's a file based type of paper. But if you're going to go to a hospital, you have to think to bring that paper with you to the hospital or to the doctor. So those are the two most, I guess, antiquated as far as limitations. The other limitation, which becomes a big clinical limitation to them, is that they're interpretable. meaning someone has to read it and make a decision. And that decision, often just, and I don't nonchalantly say this, is often a guess. And it's often a guess by a medical provider who doesn't really know you as far as what they're supposed to do to save your life or to allow you to die naturally. That becomes the biggest clinical limitation of those documents in and of itself. So, know, good idea to put one of these documents in place to think through what you might want if you were in search of circumstance and to communicate it to your family and then to formalize it, but in practice doesn't work out necessarily so well. So that's where MEDEO comes in. And I wonder how is MEDEO different from the traditional approaches? What are some of the benefits of what you do? Great question. So first and foremost, when Living Wills came about, they were never really evidence-based, right? It was a good idea by somebody. It was a good idea by someone, hopefully, to have a person at that time when they were created decline life-saving care and treatment, right? They then subsequently morphed, you that you can accept or decline life saving treatment with them now. So that in and of itself became an issue. Right. So the other issues that come with these types of documents and directives is, again, we we come back to that whole point of whether or not people understand them correctly and the limitations behind them and so on. So what we did with Mideo to make this all a better process is to really bring an evidence base to it. So we have research, we have patient safety research called the triad research that has spanned decades of times now that we took the same issues related to the documents, figured out fixes to them and actually made this a safer process for patients. Kind of like a stop guard measure. Essentially, before you enact you get to now look at a video of a patient actually explaining to you what they want in terms that you can understand as a physician. All makes good sense. And I went through this process with you. I'll show the card that I got. It's complete with QR code, my picture, and it's got witnesses signed and my own signature and a link to that paper document that the healthcare system cherishes so much in case they want to get that and download it. They do want paper, don't they? Yeah, indeed. Indeed. Well, good. Well, that's it for the latest Health Biz Brief. If you like what you hear, check out my Health Biz Podcast. for a full-length interview with Dr. Maracci about his life and career. Dr. Fernando Maracci, CEO of Midio, thanks for joining me today on Health Biz Briefs. Thank you. Thank you for having me.