The document that could save your life is in a drawer at home whilst you are in a hospital abroad. Paper advance directives fail at the moment they matter most, not because the content is wrong, but because the document is not accessible when a clinical team needs it. Most people who have created one cannot say with certainty where it is right now. Most people who have not created one cite the same reasons: the process is intimidating, the language is clinical, and the result is a piece of paper that nobody checks during an emergency.
An advance directive is a legal document that records an individual’s preferences for medical treatment in situations where they are unable to communicate those preferences themselves. When backed by Patient Blood Management principles, it addresses not only what treatments a person consents to or declines, but how clinical teams should optimise the patient’s own biological resources during care.
What MyPBM does
MyPBM turns the advance directive from a static paper document into a living digital record, backed by evidence-based clinical principles and accessible from any device. The process is designed to be clear enough for a non-medical person to complete, yet precise enough for a clinical team to act on.
Rather than presenting medical terminology and asking individuals to interpret it, MyPBM explains each treatment option, its purpose, and its implications in plain language. The goal is not to simplify the medical content but to make it accessible without sacrificing the precision that clinicians require. Every preference recorded maps to the evidence-based Patient Blood Management framework, ensuring that the resulting directive speaks the same language as the clinical team that may one day read it.
The output is a digital document available in four export formats, covering everything from informal personal reference to formally witnessed legal documents suitable for jurisdictions that require specific witnessing procedures. The document lives in MyPBM’s secure platform and can be updated at any time. Every change takes effect immediately, and the emergency QR code always resolves to the most current version.
Why Patient Blood Management matters
Patient Blood Management is an evidence-based clinical framework endorsed by the World Health Organisation, and understanding it changes how you think about what an advance directive should contain. PBM is not about refusing treatment. It is about ensuring that clinical teams have clear, informed preferences to work with before a critical moment arrives.
The WHO published comprehensive PBM guidance in March 2025, a 216-page document establishing PBM as a foundational standard of care rather than an optional protocol. The framework rests on three pillars: optimising the patient’s own blood production before intervention, minimising bleeding and blood loss during treatment, and harnessing the body’s physiological tolerance during recovery. Each pillar represents a shift from the historical default of treating blood loss primarily through donor transfusion.
The connection between PBM and advance directives has deep roots. Historically, treating patients who declined transfusions through advance directives forced the medical community to develop non-transfusion alternatives. Techniques such as maintaining iron stores, optimising haemostasis, and using cell salvage technology emerged directly from the need to provide optimal care within patient-defined boundaries. Those techniques now form the foundation of modern PBM practice, applied to all patients regardless of their transfusion preferences.
This history is worth knowing because it reframes what an advance directive can be. These are not obstacles to good care. When they are clear and accessible, they enable clinical teams to prepare alternative care pathways in advance rather than improvising under pressure. A well-constructed advance directive does not limit the care you receive. It shapes it.
Emergency access
Every MyPBM directive generates a QR code that gives a first responder or hospital team immediate access to your critical preferences, with no app download required. The emergency view is designed for the conditions under which it will actually be used: quickly, under pressure, by someone who has never seen your document before.
The QR code links to a limited view showing the information most relevant to immediate clinical decisions: critical treatment preferences, key medical conditions, and emergency contact information. This is deliberately not the full directive. A trauma team in the first minutes of care needs a focused subset of your preferences, not a comprehensive document to read through. The full directive, with its detailed preferences across a wider range of treatment scenarios, remains accessible to anyone you have specifically authorised.
The distinction between emergency access and full access is a design decision, not a limitation. Emergency access is fast and unrestricted because restricting it behind a login would defeat its purpose. Full access remains under your control because your complete medical preferences are yours to share selectively.
Privacy and control
You decide who sees your directive, and you can change that decision at any time. MyPBM does not share data with insurers, employers, or third parties. The only access that operates outside your direct control is the emergency QR code, and that exists by design because it needs to work when you cannot unlock it yourself.
Access permissions are straightforward. You grant access to specific people, and you revoke it when you choose. There is no approval process, no waiting period, and no intermediary. When your preferences change, you update the directive and the changes take effect immediately. The QR code resolves to the current version. Previous versions are retained for your own reference but are never served to anyone else.
The simplicity is deliberate. Medical preferences are personal, and the system that manages them should not introduce complexity beyond what is necessary to keep them secure and accessible to the right people at the right time.
Available now
MyPBM is live at www.mypbm.app. The platform is available to individuals in any jurisdiction, with export formats designed to accommodate varying legal requirements for advance directive witnessing and validity.
For more detail on how MyPBM approaches digital advance directives, see the product overview.