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ePOLST

MOLST to POLST Transition

Massachusetts is currently undergoing an initiative to transition from Medical Orders for Life Sustaining Treatment (MOLST) to Physician Orders for Life Sustaining Treatment (POLST). The need for streamlined sharing of MOLST forms, healthcare proxy documents and other advance directives is a primary impetus for the POLST transition.  

The POLST initiative is more than a form change, it is a change of behavior. The initiative will emphasize working and training Massachusetts providers in evidence-based, serious illness conversation training.   

The POLST form is the new national standard for patients and their providers to ensure patients’ needs and desires are met during serious illness and end of life treatment. Many States across the country have statewide use or are working towards statewide use of the POLST form. (National POLST: POLST Use by State).  

In Massachusetts, the POLST program will also involve the rollout of an electronic POLST (ePOLST) registry, as the new form is electronic.  

Stakeholders identified electronic access to patient Medical Orders for Life Sustaining Treatment (MOLST) forms as a critical need with a high potential to significantly improve the quality of end-of-life care.  As part of the evolution of its MOLST program, Massachusetts applied to join the National POLST Paradigm. 

Based on this proposed MOLST update, stakeholders recommended that Massachusetts introduce an e-MOLST solution in tandem with the DPH statewide rollout of an updated paper-based MOLST form. 

For more updates, visit the MOLST to POLST Advisory Group page on the Massachusetts Coalition for Serious Illness Care's website.

Electronic Sharing of Advance Care Planning Documents  

The ePOLST registry will be an interoperable data repository for providers, patients and patients' families to share the respective documents. This initiative will further enhance patient care and compliance with patients' needs, wants and desires during serious illness and/or end of life care.   

Currently, the project has wrapped up the contracting phase. The Center for Medicare and Medicaid Services (CMS) has approved the ePOLST registry vendor contract, and the respective contract was fully executed by Massachusetts Executive Office of Health and Human Services (EOHHS) and the ePOLST vendor, MyDirectives, during July 2024. The first phase of POLST piloting will start during Fall of 2024. 

For more updates, visit the MOLST to POLST transition page on the Massachusetts Executive Office of Elder Affairs (EOEA) site here. You may also contact MassachusettsPOLST@mass.gov to learn more about the statewide POLST initiative.

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