In the first hour after a traumatic injury or medical emergency, often referred to as the “golden hour,” it is imperative that decisions be made regarding what treatment the patient wants.

The information necessary to make these decisions is found in the patient’s living will and health care power of attorney. The problem lies in doctors not having quick and easy access to this information, especially if a patient is unconscious or unable to communicate.

Located on the second floor of an office building in the heart of Narberth, Pennsylvania, Advance Choice Inc. provides its members with a wallet card that displays information doctors can use to immediately obtain vital documents that dictate the patient’s desired health care decisions during an emergency. The card works 24 hours a day, seven days a week.

These documents are referred to as one’s advance directives.

In a 1995 study by Sean Morrison, M.D., advance directives were found to be unavailable at hospitals 74 percent of the time when needed. Similar research conducted since then has also found that primary care doctors do not know that their patients have completed an advance directive in over two-thirds of cases.

The service provided by Advance Choice Inc. is called DocuBank, as it provides a secure bank for one’s important documents.

In 1990, the federal Patient Self-Determination Act passed by Congress gave citizens the right to have hospitals honor their medical wishes through the use of advance directives.

After working in a nursing home and implementing policy to adhere to the newly passed law, John Harris saw a business opportunity.

“Under the new law, hospitals were required to ask patients if they had a living will,” said Harris. “My idea was that I would provide a service for people to store those documents and fax them if they’re hospitalized.”

In 1993, Advance Choice Inc. was born.

A patient’s advance directives can be retrieved either by hospital staff and doctors online through the service’s website or by calling the DocuBank toll-free number.

“When a hospital employee calls 1-800-DOCUBANK, an automated recording asks for the member number and PIN, and by the time the recording ends, their fax machine is ringing,” said Advance Choice Inc. President Randi J. Siegel, wife of co-owner Harris.

Unlike many of its competitors, DocuBank also gives its members the ability to store other personal, non-medical documents in its related service, called SAFE. The documents stored can include deeds, insurance policies and estate plans.

“We are the high end provider with higher touch, more client service and we also have many specialized additional features,” said Siegel on what she believes separates Advance Choice Inc. from other competitors.

Unique services are also provided for college students, adults with special needs, the LGBT community and clients' children who are still minors.

Appropriate material and information is provided to LGBT members, as difficulties can arise in states where gay marriage is not legalized and the person’s life partner is not legally recognized as a viable health care decision maker.

“It’s a patient-focused business and we’re doing our part in making sure that our members’ end of life wishes are recognized during tough times,” said Kelly Nagy, a production manager and the LGBT coordinator who has worked at Advance Choice Inc. for the last 11 years.

Now the oldest and largest advance directives registry in the country, DocuBank has enrolled more than 250,000 members. Since its inception in 1993, Advance Choice Inc. has seen only two years in which revenue fell.

Since much of their distribution strategy involves traveling to sell the service to attorneys, revenues dipped following 9/11. When the stock market crashed in 2008, another dip was experienced. Each drop was followed by the continuing general upward trend that now brings in more than $1 million in revenue a year.

Under the Patient Protection and Affordable Care Act of 2010, incentives were created for increased advance care planning.

“It is my hope that we will be able to work with hospitals and health systems to offer this service directly to them, as a way of helping people clarify and document their health care wishes,” said Siegel.

DISCLOSURE: Author Ben Harris has a personal relationship with John Harris and Randi J. Siegel.