NPC Position on the National POLST Form in EPIC
The National POLST Collaborative (NPC) has recently been made aware of activity within the EPIC foundation platform incorporating the National POLST model form. This has been done without permission, input or approval of NPC.
As our members and other state programs are aware, each state has their own laws, regulations and language governing the validity of POLST (and other named order sets) as actionable, portable medical orders. The National POLST document is a model form that must be adapted or adopted by each individual state for use and must include the state-designated name or acronym (e.g., POLST, MOLST, POST, MOST, T-POPP, LaPOST).
We are attempting to work with EPIC to discuss further steps to rectify this problem. In the meantime, we recommend states communicate with their providers and health systems that only state-developed and approved forms are valid, and that utilizing the generic National POLST model form may jeopardize patient care if implemented. We plan to work on this issue and will provide more clarification and guidance soon.
Link to the official letter: NPC Response to Epic
What is POLST?
POLST has different names in different states. At the national level, it is simply called POLST: Portable Medical Orders, or POLST for short.
Portable Medical Order
(advance directives, living wills, etc)
|Provides specific medical orders when patient cannot communicate.
|Identifies surrogate decision-maker and provides general treatment wishes (not orders) for individual.
|Seriously ill and frail individuals
|All competent adults
|Can Emergency Medical Services use?
|Provider completes. Patient or surrogate signs.
|Individual completes and signs. Usually notarized.
Compare POLST medical orders and legal advance care planning documents in the above table.
What is National POLST?
National POLST is an independent 501(c)3 non-profit organization that organizes the effort to standardize the POLST process, form and education throughout the U.S., since POLST varies from state to state. Learn more about the history of POLST and National POLST and its name and logo.
Your state is likely helping set POLST standards by being part of National POLST. For information about what is happening with POLST specifically where you are, get in touch with the POLST leaders in your state. You can look up them up at our Directory of POLST Programs.
Download our 2-page overview of National POLST (PDF).
Support for National POLST
The Institute of Medicine, now the National Academy of Medicine, encouraged all states to create a POLST program that meets national standards in their 2014 report. National POLST has also attracted the support of many organizations: