Briefing — Exploring the Need for a POLST Registry in California

Sacramento Briefing

Hear about Oregon's successful implementation and the benefits and options for California to create a registry for POLST forms, which communicate patient preferences for treatment.

Held: December 3, 2014

In an emergency, Californians don't always get the kind of medical treatment they want, especially if they can't speak for themselves and there is no readily available record of their preferences. Emergency medical professionals often need immediate access to this information so they can provide care that accommodates a patient's wishes.

The Physician Orders for Life-Sustaining Treatment (POLST) form enables seriously ill individuals to outline the treatments they do or do not want in emergency situations. The form, signed by both the patient and his or her doctor, lets other doctors, hospitals, and first responders provide or withhold medical treatment with the knowledge that they are adhering to the patient's wishes.

California legislation enacted in 2009 requires health professionals to honor the preferences detailed in the POLST form wherever treatment is provided.

Currently, few health care systems are able to seamlessly share POLST information when a patient is transferred between locations, such as from a nursing home to a hospital. The absence of a way to share POLST across these settings can often impede providers from upholding patients' wishes.

Presenters at this CHCF briefing explore the potential benefits of creating an online POLST registry, share results from Oregon's successful POLST registry implementation, and discuss findings of a recent assessment that identified options related to establishing a POLST registry in California.

Speakers include:

  • Robert Moore, MD, MPH, chief medical director for Partnership Health Plan, a Medi-Cal managed care plan with some 500,000 members in 14 Northern California counties
  • Judy Thomas, JD, executive director of the Coalition for Compassionate Care of California, a statewide collaboration of health care providers, consumers, and regulatory agencies working to improve care of seriously ill Californians
  • Susan Tolle, MD, founding member of the Oregon POLST program, director of the Center for Ethics in Health Care at the Oregon Health & Science University, and a professor and practicing internist
  • Neil Wenger, MD, MPH, director of the Health Ethics Center at UCLA, a professor in the school of medicine, and a practicing internist who focuses on patients with complex illnesses

A recording of the event and the speakers' slides are available below.