From Protocol to Personal: Keystone Law Firm and the Impact of Digital Healthcare Directives

Not long ago, a woman arrived at the hospital with her husband, who was experiencing a medical emergency. All she wanted was to stay by his side and ensure the staff followed his wishes. Due to protocol, the medical team was unable to share any information on his care and treatment plan with her, as they couldn't verify her identity as his wife and approved Heathcare Power of Attorney through his advance directives.

Advance directives are simply documents that outline what healthcare and treatment decisions should be made if someone is unable to communicate their wishes and preferences on their own.

Instead of leaving his side to return home and find their advance directives, she remembered that her attorney, Michelle Dexter from Keystone Law Firm, had helped them create their advance directives and store them safely in a central online platform. This allowed her to access them digitally anytime, anywhere.

With her physical advance directives wallet card in hand, she scanned the QR code and instantly produced his records through the registry, enabling her to stay involved and make the decisions she knew he wanted. 

The Accessibility Challenge  

Keeping advance directives in a safe yet accessible place is crucial. Often, living wills and other advance directives are stored under lock and key, such as in a safety deposit box or a locked filing drawer at home. While these options are safe, they are not easily accessible. If the Keystone Law Firm's client had them stored at home, the medical team wouldn't have been able to verify her authority or allow her to be involved in her husband's medical treatment without leaving his side and returning home to collect the documents, adding stress to an already difficult situation. 

Solution: Arizona Healthcare Directives Registry  

The Arizona Healthcare Directives Registry (AzHDR) is a secure online platform designed to provide dynamic access to advance directives. Managed by Contexture, the largest health information organization in the western United States, the AzHDR ensures that these critical documents are accessible when they are needed most. 

Expanding Access Beyond Healthcare

Contrary to the myth that only healthcare entities are involved in advance directives, many institutions such as – law firms, financial planners and fiduciaries, play a vital role in guiding and supporting clients through these important conversations. 

“I continue to use the Healthcare Directives Registry because my clients value it so much,” shared Michelle Dexter, Managing Attorney at Keystone Law Firm. Dexter often hears from her clients how the AzHDR QR code wallet card improves accessibility and reliability.

Keystone Law Firm promotes the registry with clients because it facilitates easy access to critical documents during times of emergency when their offices may be closed.

“I would encourage all [law] firms to register their client’s documents. It does not take a lot of additional effort and ideally most will not need it, but if clients do, it is the most efficient way to get the information in the hands of those who need it.”

Michelle Dexter, Managing Attorney

The Registry's Growth

Over the past four years, the AzHDR has significantly expanded to support more Arizonans. As of 2025 over 450 organizations utilize the registry including healthcare providers, law firms, financial institutions, and community-based organizations. With over 120,000 Arizona registrants and counting, more individuals have confidence knowing their healthcare wishes are documented and readily available, providing invaluable support during critical moments.  

Keystone is educating the next generation

For the past eight years, Dexter has been dedicated to educating the public about proactive planning, a mission aligned with the AzHDR and Contexture. What started with just a handful of young adults signing up for her lecture on advance directives during their senior year of high school, has now become a highly anticipated sold-out event with multiple sessions hosted every Spring.

Dexter's mission is to prepare for the worst, ensuring her clients' wishes are verified and acted upon during emergencies. The healthcare directives registry is a key tool that supports this mission, enabling individuals to document and share their healthcare decisions in advance.

About Keystone Law Firm

Keystone Law Firm helps Arizona families protect their legacy with personalized estate planning. Get peace of mind for your future, call 480-418-8448 or email info@keystonelawfirm.com. Learn more at KeystoneLawFirm.com.

About the Arizona Healthcare Directives Registry 

There is no cost to utilize this program, and healthcare directive advisors work tirelessly behind the scenes to ensure all documents from individuals, health entities and legal/financial firms meet statutory requirements before adding them to the registry.

The healthcare directives registry is designed for both individuals and organizations.

The AzHDR team is available to demonstrate the system and walk any practice through the simple steps so any organization can take to start using the Arizona Healthcare Directives Registry. Learn more at azhdr.org or by emailing azhdr@contexture.org.