Increases in Advance Directive Completion Through the Patient Portal Among Younger and Healthier Population During the COVID-19 Pandemic

<b><i>Objectives:</i></b> To identify differences in the number and characteristics of patients who completed a Medical Durable Power of Attorney (MDPOA) form through the patient portal during the COVID-19 pandemic compared to pre-pandemic. <b><i>Methods:</i></b> Data, including portal-based MDPOA forms, were extracted from the electronic health record at one U.S. institution (July 2017-May 2023). The pandemic period was defined as March 26, 2020, or after. <b><i>Results:</i></b> 397,682 patients added an MDPOA form during the study period. There was an increase in the proportion of portal-based MDPOA forms from 4.6% pre-pandemic to 5.1% during the pandemic (<i>p</i> < 0.001). Patients who used the portal to complete the MDPOA form during the pandemic were younger (<i>p</i> < 0.001) and had fewer comorbidities (<i>p</i> < 0.001) compared to pre-pandemic patients who completed a portal-based MDPOA form. <b><i>Conclusion:</i></b> MDPOA completion is important for patients of all ages and health statuses. Having MDPOA tools within a patient portal can support uptake among younger, healthier populations.