Documented medical wishes can only inform care if they are known. We look at the landscape for adoption of a POLST registry in California and successful registries in other states.
Physician Orders for Life-Sustaining Treatment (POLST) forms allow individuals to articulate their wishes about intensity of care in the event of a serious illness. However, completing a POLST form isn't enough; it must also be easily accessible during a crisis. How will emergency responders know a patient's treatment wishes if that person cannot communicate or if that person's POLST form or medical record is not available?
One solution is an electronic statewide registry, which would securely store patients' POLST information and make it accessible by medical personnel at any time.
CHCF hosted a briefing in December 2014 to explore the potential benefits of creating an online POLST registry in California, share results from Oregon's successful registry implementation, and discuss findings from a survey of a wide range of health care stakeholders and POLST leaders on this topic.
This brief, informed by the survey of health care leaders, describes the landscape for a POLST registry in California by looking at models and lessons learned from other states, the benefits of a statewide registry, and possible next steps to successful implementation and adoption of such a registry.
Legislation to Watch
In December 2014, Senator Lois Wolk introduced Senate Bill 19, the California POLST Registry Act, which proposes the establishment of a state POLST registry to be operated by the California Health and Human Services Agency. SB 19 is currently under consideration.
Next steps identified by interviewees:
- Pilot the registry in a community, with the intent to scale rapidly.
- Develop a technology platform for the registry that supports multiple forms of input and output, from paper to fax to mobile devices.
- Expand existing POLST education infrastructure to include education about the registry.
- Engage state administrative leadership and consider development of an independently operated registry, based on the approaches of other successful California health registries, such as the California Cancer Registry.
- Identify funding sources to build and sustain the registry.
The full issue brief is available under Document Downloads.