Can apply to both UCSF Medical Center and SFGH.  SFGH is hampered to a greater degree given the lack of an integrated EMR system.  Efforts should be taken to standardize the location of advance care planning documenation in the EMR.  Often a great deal of time may be taken by providers to obtain ACP documentation, but then there is no standard place or processes around documenting such materials.  Or if there is a place, processes and practice are not standardized to ensure that information is recorded in a reliable fashion and location.  This leads to inaccessibility of important information at critical points of care across the care continuum (Ex. ED, after a hospitalization back in the PMD office, ICU, etc...)