Welcome to the POLST eRegistry Pilot Toolkit!
The purpose of this toolkit is provide health care providers in Contra Costa County and San Diego the guidance they need to participate in the California POLST eRegistry pilot project, including technical information and POLST best practices.
Throughout this toolkit you will find resources, information, potential solutions for workflow efficiencies and external links designed to provide you with a comprehensive understanding of Physician Orders for Life-Sustaining Treatment (POLST) and the POLST eRegistry Pilot.
The POLST eRegistry Pilot project is a joint effort of the California Emergency Medical Services Authority (EMSA), the California Health Care Foundation, and the Coalition for Compassionate Care of California (CCCC). The project is being funded by California Health Care Foundation.
POLST helps give seriously-ill patients more control over their care, and as such, is an important tool for person-centered care. The quality and effectiveness of POLST hinges on providers and patients or their surrogates accomplishing three core tasks:
- Engaging in a meaningful discussion to explore and clarify the patient’s personal values, goals of care and treatment preferences in the context of her/his current condition.
- Accurately incorporating the discussion and the patient’s treatment preferences into portable medical orders in the form of a valid POLST.
- Ensuring that the POLST information is immediately available when it is needed — particularly during a medical emergency.
How to Use the Toolkit
This Toolkit is divided below into five main sections: (1) POLST Best Practices, (2) Contra Costa Pilot Community Resources, (3) San Diego Pilot Community Resources, (4) POLST Form and (5) Additional Resources. The Contra Costa and San Diego pilots are testing different registry platforms, so the registry instructions, tools and resources are specific to the community. POLST best practices can be applied across both communities.
POLST Best Practices
While a POLST eRegistry can significantly improve the availability of POLST information, the value is meaningless if the information the eRegistry contains is not accurate or valid.
- POLST Best Practices (PDF) — Best practices for quality POLST completion.
- Registry Ready (PDF) — Quick guide to ensuring POLST forms are actionable and ready for input into the POLST eRegistry.
POLST General FAQs
- POLST FAQs for Providers (PDF)
- POLST FAQs for Clinicians (PDF)
- POLST FAQs for Non-Clinical Staff (PDF)
POLST in Skilled Nursing Facilities
- POLST QAPI Toolkit for Skilled Nursing Providers (PDF) – Designed to provide skilled nursing facilities with useful, QAPI-based tools which can be used to improve POLST utilization in California’s nursing homes and assure that residents’ end-of-life treatment wishes are understood, documented and followed.
- Quick Reference on POLST for SNFs (PDF)
POLST Training & Education
- POLST Train-the-Trainer (Coalition for Compassionate Care of California)
- Working with POLST for Professionals (Web-based/CSU Institute for Palliative Care)
- POLST Community Workshops
Contra Costa Pilot Community Resources
Overview of Contra Costa County pilot
The Contra Costa County pilot is being managed by the Alameda/Contra Costa Medical Association, in coordination with the Coalition for Compassionate Care of California. The eRegistry technology vendor in Contra Costa is Vynca.
Access to the Contra Costa POLST eRegistry is limited to licensed health providers through:
- Epic – POLST eRegistry integration through Epic allows users to submit POLST forms, search the eRegistry and view POLST forms. Epic is one of the largest electronic health records (EHR) vendors for hospitals and healthcare systems.
- PointClickCare – POLST eRegistry integration through PointClickCare allows users to submit POLST forms, search the eRegistry and view POLST forms. PointClickCare is one of the largest electronic health records (EHR) vendors for skilled nursing facilities.
- EMS ePCR – POLST eRegistry integration through AMR (ambulance provider) MEDS allows EMS providers to search and view POLST forms in the eRegistry.
- Upload Service – Providers in Contra Costa County who are not utilizing Epic or PointClickCare EHR systems will be able to upload POLST forms to the registry so that organizations with integrated EHR access and Emergency Medical Services personnel in Contra Costa County will be able to view those POLST forms across care settings. Upload Service users can view only the forms they (or their designates) have entered. Ability to view other forms in the registry requires EHR integration described above.
- Back-up Call Center for EMS/ER: A 24/7 call center will be available to EMS personnel for rare instances where internet connectivity to the eRegistry is not possible.
Submitting POLST Forms in Contra Costa County
- Upload Service (only for Users Not on Epic or PointClickCare)
Searching and Retrieving POLST in Contra Costa County
- Step-by-Step for Epic System Users (Coming soon!)
- Step-by-Step for Point Click Care Users (Coming soon!)
Additional Contra Costa Resources
- Alameda/Contra Costa Medical Association
San Diego Pilot Community Resources
Overview of San Diego pilot
The San Diego POLST eRegistry pilot is being managed locally by San Diego Health Connect, a not-for-profit, regional health information exchange (HIE). The eRegistry technology vendor in San Diego is Stella Technology.
Access to the San Diego POLST eRegistry is limited to licensed health providers through a feature within the San Diego Health Connect HIE portal.
2017 California POLST Form – The California POLST form was updated in 2017 to add language in the lower right-hand corner which reads, “Your POLST may be added to a secure electronic registry to be accessible by health providers as permitted by HIPAA.” POLST form versions with effective dates of 1/1/2009, 4/1/2011 or 1/01/2016 are also valid and may be entered into the POLST registry.
- Buying/Printing Blank POLST forms: A blank PDF of the 2017 California POLST form can be downloaded for printout at https://capolst.org/polst-for-healthcare-providers/forms/, or ordered in bulk quantities through Med Pass.
- POLST Informational Cover Sheet: An optional POLST cover sheet which addresses some common consumer questions about POLST can be downloaded and shared.
- POLST Translations (for reference): CCCC provides translations of POLST in 13 languages. Translations are provided for reference only, to assist healthcare providers in explaining the form to patients and loved ones. The POLST form must be completed and signed in English so that emergency medical personnel and other healthcare providers can easily read and follow the orders.