ePOLST and POLST in EHRs

What is ePOLST?

ePOLST stands for electronic POLST. However, it does not imply just a digital file of a POLST form, such as PDF. By ePOLST, we mean a computer software system designed to:

1. Assist patients by providing some education about POLST. This may include:
   1. Print materials
   2. Educational videos
2. Assist the health care professional by walking them, step-by-step through POLST process, beginning with questions relevant to the POLST conversation.
3. Record the patient’s preferences for health care treatments, saving them to a digital record associated with the patient.
4. Result in a digital POLST form that is saved to the patient’s record, and is printable so that a copy may be provided to the patient immediately.
5. Securely transmit or provide an electronically transmittable form (PDF or equivalent data) to other appropriate health care organizations or POLST registry.

POLST and Electronic Health Records (EHR)

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.