POLST Registries: Why, When and How

Terri Schmidt MD, MSProfessor, Department of Emergency

MedicineDirector, Oregon POLST Registry

February 16, 2012

POLST MOLST MOST POST POLST MOLST MOST POST POLST MOLST MOST POST

Why?

Frequently (up to 25% of EMS calls) the form cannot initially be foundPeople do not always want their form visible for all to see

Schmidt TA, Hickman SE, Tolle SW, Brooks HS: The Physician Orders for Life Sustaining Treatment (POLST) Program: Oregon emergency medical technicians’ practical experiences and attitudes JAGS 2004; 52:1430-34.

When?

• Early in POLST implementation?• Once well established?

How?

• Know your state strengths and weaknesses• Mandate submission?• Education, education, education• Call in number?• Web-based?• Proprietary product?• Who owns the Registry?

The Oregon POLST Registry• Secure electronic registry of

POLST orders.

• Located at the Emergency Communication Center at OHSU

• Allows EMS, emergency departments and acute care units access to POLST orders 24/7

States developing Registies

• Oregon• West Virginia• New York• Montana• Utah• Others…

How did it happen in Oregon?

• Piloted the concept at the county level• Created and funded by the Oregon legislature

in July 2009• Division of duties– State- funds the registry– Center for Ethics – responsible for education and

forms

Keys to Success

• Submission mandate• Education• Responding to the unexpected– ICU access– High ED use

• Questions?

Thank you to Oregon POLST Registry staff