California Health Care Foundation

A pilot project to establish an electronic registry for POLST forms in California could enable quick access to this information by emergency responders and others.

March 2016
Physician Orders for Life‐Sustaining Treatment (POLST) is a standardized medical order form that indicates which specific treatments, such as a ventilator or feeding tube, a seriously ill patient does or does not want. Unlike a health care directive, a POLST form is signed by the patient and physician and is intended to serve as medical orders that move with the patient across settings of care.

Forty-seven states have adopted POLST. New York, Oregon, Utah, and West Virginia have established electronic registries that store, manage, and provide access to POLST forms. A recent study in Oregon found that people with advanced illness or frailty who had a POLST form had their wishes honored 94% of the time.

In October 2015, under Senate Bill 19 (Wolk), the California State Senate authorized a pilot test for an electronic registry (POLST eRegistry). The legislation issues a mandate for providers in the pilot locations who completed a form to submit it to the registry, and the identification of a state agency — the Emergency Medical Services Authority (EMSA) — as the lead agency for the pilot.

With CHCF’s financial and technical support, EMSA and the Coalition of Compassionate Care in California are working to develop the POLST pilot registry initiative. The project would provide staff resources necessary to complete the following key activities, which would inform efforts to develop a permanent POLST registry in the state:

Create a cloud-based registry for completed POLST forms
Select pilot locations to test ways to submit and retrieve POLST forms
Evaluate the success of the work
Following competitive selection processes, the technology platform and the test sites have been selected and the pilot is underway.