Many states report interest in POLST Registry development, but in the most recent survey (2017) conducted by the National POLST Paradigm, only six states confirmed that a POLST Registry exists for their program:
|POLST Paradigm Program (State)||POLST Registry Website|
|New York||eMOLST Registry|
|Oregon||Oregon POLST Registry|
|West Virginia||West Virginia E-Directive Registry|
POLST Registry Information/Map
This map reflects registries that include state POLST Program leaders and where the goal of the registry is to be statewide
Reports, Webinars, and web pages with information about Registry development:
Pathways to POLST Registry Development: Lessons Learned
Project supported by the Retirement Research Foundation and Archstone Foundation
ePOLST stands for Electronic POLST. In this context, it does not imply just a digital file of a POLST form, such as PDF, whether that digital file is of a scanned paper POLST Form or a form filled out using computer software. Instead, by ePOLST, we mean a computer software program that does even more. Though ePOLST systems vary, generally they will:
- Assist patients by providing some education about POLST. This may be accomplished by a variety of means, including printed supporting materials or video designed to help patients understand POLST.
- Assist the POLST Process by walking the health care professional through the steps of the POLST, beginning with questions relevant to the POLST conversation.
- Record the patient's preferences for end-of-life treatment, saving them to a digital record associated with the patient.
- Result in a digital POLST form (most likely in PDF format) that is saved to the patient's record, and is printable so that a copy may be provided to the patient immediately.
- Securely transmit or provide an electronically transmittable PDF (or equivalent data) to other appropriate health care organizations or POLST registry.
Programs or vendors known to have developed and use robust electronic POLST (ePOLST) systems include Vynca (in Oregon, with other states in development) and MOLST (in New York). Many other programs report interest in developing such platforms, but the barriers are multiple and complex, including: the development of secure electronic completion systems, integration of ePOLST form completion software with Electronic Medical Recordkeeping systems, the secure exchange of patient ePOLST forms across various health systems (or submission into an electronic repository), accessibility of forms across multiple systems, the integration of scanned paper POLST forms with ePOLST repositories, the 24/7 availability of POLST forms to appropriate individuals (e.g., EMS), and funding to not only design but develop and maintain such systems.
|Point Click Care
|PLEASE NOTE: The National POLST Paradigm does not endorse vendors. We only provide the information (after vetting) if a vendor contacts us and wants to be listed on the National POLST Paradigm website. We encourage any facility or organization interested in electronic POLST completion or registries to conduct their own diligence to determine if these (or other vendors) comply with applicable laws or regulations.|
Essential to POLST is the ability to access the POLST form, which contains the medical orders that are to be enacted according to the patient's end-of-life care preferences. Whether clinics use paper or electronic health records (EHR), the POLST form must be prominently and immediately accessible within the patient chart. EHRs may or may not be integrated with ePOLST software modules; regardless, it is critical that there be a provision for simple and quick access to a patient's POLST form, or at least an alert as to whether a POLST form exists for any given patient, so that health care professionals may act appropriately in the case of a medical emergency. Advance Directives take time to interpret and are typically lengthy, making them less effective in an emergency; additionally, advance directives are legal documents rather than medical orders that health care professionals are prepared to follow.
Recommendations for Integrating POLST with Electronic Health Records
National POLST Paradigm Task Force (2016)