IMPACT UPDATE | POLST Quality & Electronic Exchange

Originally posted on December 9, 2020

Advancing POLST Quality Through Electronic Exchange

As the home of California’s Physician Orders for Life-Sustaining Treatment (POLST) program, the Coalition for Compassionate Care of California (CCCC) has been leading the way on POLST implementation and quality for more than 13 years. This year, CCCC took major steps forward to the goal of creating a statewide electronic registry for the POLST form, so that patients’ wishes for care can be made readily available and known across medical platforms and in emergency situations.

POLST became part of California state law in 2009 through Assembly Bill 3000. Since that time, CCCC has led California’s robust POLST program and serves as the hub of the POLST ecosystem, which includes POLST implementation and quality, provider and consumer education, community outreach through 26 local coalitions, and POLST registry and electronic exchange development efforts.

A statewide POLST registry has long been a key component of CCCC’s POLST vision because of its potential to support quality improvement efforts, reduce form completion errors, and ensure access to POLST information whenever and wherever it is needed. With funding from California Health Care Foundation (CHCF), CCCC has led several projects in recent years designed to organize and engage key stakeholders and establish a solid foundation for statewide exchange of POLST information. Learn more about our previous work here.

Vision, Engagement, and Recommended Practices

Building on the lessons learned from the POLST registry pilot, CCCC’s most recent registry work has focused on increasing stakeholder engagement, establishing a shared vision, and creating a set of recommended practices for exchange of electronic POLST information to guide future development, including electronic registries, interoperability, and electronic health records. Through a series of meetings and surveys, CCCC gathered valuable input on POLST registry opportunities and challenges from a broad group of stakeholders, including representatives of large health systems, state agencies, payers, physician leaders, skilled nursing providers, technology vendors, and consumer groups.

Growing Support

Building awareness and support for POLST and a POLST registry among state public policy leaders has been a key part of CCCC’s recent efforts. The development of California’s Master Plan for Aging (MPA) and the appointment of CCCC’s CEO, Judy Thomas, JD, to the MPA Stakeholder Advisory Committee recently provided a valuable opportunity for CCCC to educate and inform public policy leaders about the importance of POLST and the potential benefits of statewide electronic exchange of POLST information. As a result of CCCC’s advocacy, the MPA recommendations include a specific goal of “Honoring wishes of Californians at the end of life, including implementing a statewide registry for electronic exchange of POLST,” an important step in legitimizing our efforts.  Learn more about the Master Plan on Aging work here.

To support engagement and keep CCCC stakeholders informed of our progress, CCCC recently hosted a free webinar POLST Registry: Project Status, Update, and Future. Nearly 400 people attended the webinar, demonstrating strong interest in an electronic solution for exchange of POLST information in our state.

Learn more about our POLST registry work on our website.

What’s Next

 CCCC’s next steps will focus on legislative work and continuing to build stakeholder engagement.  We will be seeking clarity in state statute so that electronic aspects of POLST (completion and exchange) can move forward.  We are also looking to secure state leadership to help support POLST quality and strengthen the stability and sustainability of the POLST eco-system.

CCCC is excited about the future of California POLST and the potential for statewide electronic exchange of POLST. The time is ripe for CCCC to lead the state in taking a major step forward in the future of the POLST eco-system, from advances in technology that support quality POLST completion to support and engagement from key stakeholders and growing interest from state policymakers. These are the elements that create an atmosphere that we believe support realizing our vision for a statewide framework for exchanging POLST information. CCCC is proud to be at the forefront of this work to make the vision for a POLST registry a reality.

This blog post is part of a series designed to offer a deep dive into the Coalition for Compassionate Care of California’s recent work and the direct impact this work is having in improving care for people who are seriously ill, as well as supporting and growing the movement to transform serious illness care. A new post on a different area of CCCC’s impact will be published every other week. You can receive these updates in your email when you sign up for our eNewsletter. This work is only possible due to the financial support of our funders and donors. Please consider making a gift to CCCC today.