Across healthcare, “interoperability” has become the buzzword of the moment. Every vendor is touting it, every system is chasing it, and every policy memo seems to reinforce it. And yes — seamless data exchange matters. But in 2025, interoperability isn’t a differentiator. It’s table stakes for any organization committed to coordinated, high-quality care.

The same truth applies to Advance Care Planning (ACP).
Getting patient preferences into the EHR is only the beginning. Real impact happens when those preferences become visible, trusted, and actionable at the point of care.

Unfortunately, that’s not how most systems work today.

ACP as a PDF: Technically Interoperable, Practically Invisible

In many organizations, ACP shows up in the EHR the way it always has:
as a static PDF attachment.

It’s “there,” but only if someone knows to go looking for it. It’s “interoperable,” but disconnected from clinical workflow. It’s “completed,” but rarely used to guide care.

And that’s the problem.

A patient’s goals, values, and decision-maker shouldn’t live three clicks deep inside an attachment. They should live where clinicians make decisions — in the problem list, in the care plan, in decision support, and in the real-time tools that guide treatment choices.

From Documents to Data: How ACP Becomes Clinically Meaningful

At Koda, we believe ACP shouldn’t sit in the chart waiting to be discovered. It should shape care.

Our EMR integration pulls out the discrete, actionable elements that clinicians actually need, including:

• Surrogate decision-maker

• Core values and care priorities

• Treatment limits

• Code status

• Preferred and declined interventions

• Specific contextual preferences that matter in a crisis

These insights are then normalized, structured, and automatically surfaced in the places clinicians rely on every day: problem lists, ordersets, care plans, flowsheets, and alerts.

When ACP data shows up where decisions are made, it becomes impossible to ignore.

When Clinicians Can See What Matters, Everything Changes

The shift is immediate:

• Clinicians walk into conversations with the right context.

• Families feel aligned, supported, and included.

• Decisions are made with clarity rather than crisis-driven guesswork.

• Care becomes more personal, more consistent, and more aligned with patient values.

• Unnecessary interventions, conflicts, and avoidable costs decrease.

The best outcomes happen when what’s in the record actually informs what happens in the room.

Interoperability Isn’t Enough; Insight Is the Differentiator

Healthcare doesn’t need more PDFs or “completed” documents that sit untouched.
It doesn’t need more boxes checked.

What it needs is real-time, human-centered insight, the kind that empowers patients, families, and care teams to act together on what matters most.

That’s the standard Koda is building toward: not just interoperable data, but impactful ACP that transforms care from the inside out.

How Koda Makes ACP Actionable in Epic: Real-Time, In-Workflow Insight

Koda’s Epic integration is built to do one thing: make ACP impossible to miss — and effortless to act on.

Here’s how it works:

See Care Plan Progress at a Glance

Clinicians instantly see where a patient is in their ACP journey:

• Has the patient started the process?

• Are they reviewing values?

• Has documentation been finalized?

All of this appears right inside the chart, without requiring anyone to log into a separate platform or track down notes.

Access Full Plan History in One Click

Every version, every update, every change — automatically captured and linked in the EHR.

Providers have:

• Full visibility into the evolution of patient wishes

• Confidence they’re viewing the latest and legally valid information

• A clear audit trail of conversations and documentation

This reduces confusion, miscommunication, and outdated decision-making.

Surface What Matters Most, Discretely and Clearly

Unlike PDFs, Koda delivers ACP insights as discrete, labeled, structured data, making them impossible to overlook.

Epic users see:

• Final code status

• Confirmed surrogate decision-maker

• Treatment limitations

• Goals and values

• Specific interventions preferred or declined

These appear exactly where clinicians make decisions — problem lists, care plans, ordersets, flowsheets, and decision-support systems.

It’s ACP made actionable.

One-Click Referrals

Need a patient to start or revisit ACP?

Referrals to Koda launch directly from Epic.

No extra workflows. No new portals. No friction.

Why This Matters

When ACP data lives inside the Epic workflow, it stops being an afterthought and becomes part of everyday care.

Clinicians can:

• Act with confidence

• Align quickly as a care team

• Make decisions rooted in patient values

• Prevent unwanted interventions

• Reduce crisis-driven care conflicts

Patients receive care that truly reflects their wishes, not the wishes someone hoped were documented somewhere.

Learn more about our Epic integration for advance care planning.