Principal Findings
This Meta-LARC ACP Notification substudy implemented an embedded EHR notification to identify patients appropriate for ACP, referral to a clinical trial, and encourage ACP conversations and documentation. Approximately 10% of the patients identified by the EHR notification were referred to the study. In addition, we found that by the time providers received more than 5 notifications, providers were less likely to refer patients to the study. There was no significant difference in association among patients with more notifications (greater than 5 notifications) and ACP documentation or billing. While providers found the notification added value to their clinical care, the notification was difficult to use and was burdensome to clinical workflow.