Encouraging Older Adults and Adults With Serious Illness to Designate a Health Care Proxy

This study is a Stage III randomized trial to encourage patients in advance of a health care appointment to designate a healthcare proxy. Patients will be randomly assigned to receive a mailer containing information about designating a healthcare proxy, or to not receive any mailer. For patients assigned to receive a mailer, the mailer will differ by the presence or absence of a patient pre-commitment prompt, and contain a personalized provider request or a generic health system request. The work will evaluate the randomized trial and identify factors that predict intervention effectiveness.

Inclusion Criteria: * No EHR-documented healthcare proxy at enrollment * Age ≥ 55 years OR age ≥ 18 years and listed in the health system's cancer, CHF, or CKD registries Exclusion Criteria: * None