When a POLST form is completed based on a quality conversation between a patient and provider about the patient’s medical condition, treatment options, and goals of care, it becomes a valuable tool for person-centered care. In order to be effective in guiding person-centered care, POLST information must be quickly and easily accessible by healthcare providers, particularly emergency medical services providers. An electronic POLST registry can help ensure that information about patients’ treatment preferences is immediately available to health providers during a medical emergency, even when a paper copy is not accessible or can’t be located.

From 2015 to 2021, the Coalition for Compassionate Care of California (CCCC) managed and reported on several regional pilot electronic registries to provide proof of concept for a statewide project. In 2021, CCCC partnered with other organizations to ensure passage of legislation authorizing and funding the registry and support of the larger POLST ecosystem. From 2022 to 2025, CCCC was contracted to the Office of Systems Integration and Solutions and, later, the California Emergency Medical Services Authority to provide subject matter expertise and stakeholder management toward the development of a statewide POLST electronic Registry. This page provides background information and updates regarding the development of the POLST eRegistry.

POLST eRegistry Vendor and Launch Timeline Announced

On Friday, March 14, 2025, the Emergency Medical Services Authority posted the following announcement (emphasis and subheadings added). The Coalition for Compassionate Care of California is a member of the POLST Technical Advisory Committee mentioned below. For updates, bookmark this webpage: https://emsa.ca.gov/polst.

The planning and development work for the POLST eRegistry has been transitioned from the California Health and Human Services (CalHHS) Office of Technology & Solutions Integration (OTSI) to the Emergency Medical Services Authority (EMSA). This strategic shift will allow EMSA to maintain closer oversight of the project as it moves forward.

EMSA was previously engaged in the state procurement process to secure a vendor to begin the system build. This reflects the department’s commitment to maintaining project momentum while ensuring the right partner is selected to bring the POLST eRegistry to life.

Vendor and Timeline

The EMSA Request For Offer (RFO) was awarded on March 14, 2025, to ServiceNow for the POLST platform. The rationale being that it is an enterprise service platform that will be utilized by all EMSA programs. Also, an RFO was issued instead of an Request For Proposal (RFP) because the Department of General Services Software Licensing Program (SLP) has an existing Licensing Procurement Agreement (LPA) that lists approved vendors for ServiceNow.

POLST Technical Advisory Committee

As part of the department’s ongoing commitment to stakeholder engagement, EMSA will be launching a dedicated POLST Advisory Committee and sent out engagement letters in February of 2025 for this important initiative.

The first meeting was held May 21, 2025, virtually from EMSA Headquarters, in Rancho Cordova, California. The department welcomes participation in this workgroup as the POLST program aims to ensure that seriously ill patients can make their wishes known about life-sustaining treatment and have those wishes honored across all healthcare settings.

EMSA looks forward to collaborating with stakeholders as the project progresses through these next phases of development.

POLST eRegistry Q&A from 2025 CCCC Annual Summit

CCCC was pleased to feature a session presented by EMSA at the 2025 CCCC Annual Summit to provide a “sneak peek” at the statewide POLST eRegistry. Along with a demonstration of the software, time was provided for Q&A. Unfortunately, there were more questions than time allowed, so CCCC followed up with EMSA to get additional responses. The answers to all the questions submitted during the session are available by clicking here.

For More Information

For any questions, please contact the Health Information Unit at Healthinformation@emsa.ca.gov.


POLST Registry Development Work 2015–2021
We envision a future in which all Californians with advanced serious illness or frailty have their wishes for medical treatment at the end of life elicited and honored and where ensuring person-centered care and honoring patient wishes is always of highest priority within health care.

With funding and support from the California Health Care Foundation (CHCF), the Coalition for Compassionate Care of California (CCCC) began this work in 2015 with stakeholder groups to explore opportunities and address the challenges related to statewide access to POLST information (see below for additional information on the pilot project).

On July 12, 2021, CCCC achieved a long-held goal to secure funding in the state budget to support a statewide POLST registry and enhance the POLST ecosystem. The 2021–2022 state budget contained a one-time allocation of $10 million to establish a statewide POLST electronic registry and an annual appropriation of $750,000 to prepare POLST providers and consumers for the registry. The Emergency Medical Services Authority (EMSA) has been named the state agency in charge of the funding and project.

In late July, shortly after Governor Newsom signed the budget trailer bill (AB 133), EMSA was already reaching out to CCCC for background information and statistics regarding the California POLST program. The budget allocation did not specify a registry vendor or even a proposed structure – those aspects were explored and determined by EMSA through a planning and procurement process in consultation with stakeholders like CCCC.

Preparing the POLST Eco-System
The POLST registry pilot program taught us that a registry is not just a technology solution. POLST quality must also be addressed before and after a registry is created to ensure that the information entered into the registry is current, actionable, and accurately reflects the wishes of the patient.

POLST is designed to travel across different care settings – home, assisted living, nursing home, clinic, physician’s office, the ER, hospital and hospice. Along the various points of contact, there are numerous opportunities to demonstrate and impact quality, including conversations around serious illness and POLST, electronic POLST form standards, provider training curriculum, community outreach and engagement, reimbursement, and regulatory guidelines. CCCC is the only entity that intersects with all aspects of the POLST eco-system, and we made every effort to educate EMSA and other state-level entities about the importance of preparing the larger POLST eco-system for the registry.


Stakeholder Engagement and Recommended Practices (2019)
Electronic registries for the exchange of POLST information are currently operational in four California communities, including  Contra Costa, Inland Empire, Ventura, and San Diego. Each registry operates independently. Other California communities stand at the threshold of developing their own POLST eRegistries, and a variety of related information-sharing technologies and services are being developed in this rapidly evolving market.

To lay a foundation for future statewide exchange of POLST information, CCCC recently worked with stakeholders to:

  • Create and communicate a shared vision for POLST eRegistry in California.
  • Explore opportunities and challenges related to POLST eRegistry expansion in California.
  • Create a set of Recommended Practices to guide key areas of POLST Registry development, including electronic registries, interoperability, and electronic health records.

Related Links:

  • POLST Registry Funding and Next Steps, August 20, 2021 (Read blog post)
  • Webinar: POLST Registry | Project Status, Update, and Future, presented by Judy Thomas, JD, and Robert Cothren, PhD, Oct 14, 2020 (View recording)

Pilot Testing POLST Registry in California (2015–2018)

With funding from the California Health Care Foundation and authorization from California Senate Bill 19, the  Coalition for Compassionate Care of California (CCCC) and California Emergency Medical Services Authority (EMSA) pilot-tested POLST registries in Contra Costa County and San Diego.

The POLST eRegistry Pilot was supported by passage of California State Senate Bill 19 (Wolk) in October 2015, which authorized a pilot test for an electronic registry (POLST eRegistry) and the identification of a state agency — the California EMS Authority — as lead agency for the pilot.  SB 19 sunset on January 1, 2020.

The feasibility, functionality, quality, and acceptability of an electronic POLST registry was tested with the goal of informing and supporting the future development of statewide electronic access to POLST.  The project yielded valuable information and lessons learned which will be used to guide future efforts.

At the conclusion of the project, CHCF published a report, California’s POLST Electronic Registry Pilot: Lessons for All States, including insights and considerations for entities interested in pursuing POLST registries.

To assist other organizations preparing for electronic exchange of POLST, the pilot team also developed a POLST eRegistry Readiness Assessment Tool to identify some of the needed preconditions and capabilities, and to help anticipate and address barriers.

While the work specific to the POLST eRegistry Pilot Project has concluded, the Contra Costa and San Diego registries continue to operate independently.  The Contra Costa POLST registry is operated by Vynca, and the San Diego POLST registry is operated by San Diego Health Connect.