As part of the state Legislature's health care reform package, Oregon has launched the nation's first 24-hour electronic registry for the Physician Orders for Life-Sustaining Treatment (POLST) program. The purpose of the registry is to ensure that in all cases — especially in emergency situations — medical personnel can obtain quick and accurate information about a patient's health care wishes.
At the center of the Oregon-developed POLST program is a medical order form completed by a patient and their physician, nurse practitioner or physician assistant. The pink form provides specific medical instructions to health care professionals at a time when the patient is incapacitated. It is specifically created for patients with advanced illness or frailty. Program participants who remain at home are directed to place the form on their refrigerator.
"Oregon's pioneering POLST program was first conceived in 1991 and has now been modeled by 30 other states because it has an outstanding track record of ensuring that end-of-life wishes are followed," explained Susan Tolle, M.D., director of the Oregon Health & Science University Center for Ethics in Health Care. "Our next step is to expand and improve the program, and we thank Oregon legislators for approving the statewide registry. This 24-hour service will make it possible for a person's POLST form to be located and followed even when a patient is away from home or if a copy of the form cannot be located in their home."
"The Oregon POLST Registry, a partnership between OHSU and the Oregon Health Authority, will be a great opportunity for EMTs and paramedics around the state to honor patient preferences when patients cannot speak for themselves and the paper POLST form cannot be found," said Ritu Sahni, M.D., M.P.H., medical director of Oregon Emergency Medical Services and Trauma Systems.
Here is how the system will work: When emergency medical personnel are called to a scene to treat an incapacitated person in the advanced stages of illness, they will first look for the paper POLST form on site. If the form is not immediately available, the POLST Registry based at OHSU will be called. The first responders will inquire about the existence of a POLST form and ask questions to ensure that the person and the form are an exact match. This information then will be used to help guide the care of the patient.
Following several months of preparation, Tolle will announce on Friday Oct. 23, at a statewide hospice conference that the registry team can immediately receive completed POLST forms. The statewide program is anticipated to launch Dec. 1, 2009, under a contract agreement between the state and the OHSU Department of Emergency Medicine, which will operate the registry and hotline. In the meantime, a pilot project, launched in Clackamas County this past May, continues to both gather POLST forms and receive calls from emergency workers treating patients within that county. Patients with completed POLST forms from all over Oregon can fax or mail a copy to the registry office. Contact information for that office can be found at the end of this press release.
"Once launched, the statewide registry will provide the needed backup to the paper form and securely protect POLST orders similar to other health information," according to Terri Schmidt M.D., a professor of emergency medicine, OHSU School of Medicine, and the director of the POLST Registry project.
Other states that have followed Oregon's lead and adopted POLST programs include California, Idaho and Washington.
Contact information for submitting completed POLST forms:
Oregon POLST Registry
Mail Code: CDW-EM
3181 S.W. Sam Jackson Park Road
Portland, OR 97239
Fax: 503 418-2161
To learn more about the POLST program and the new registry visit www.polst.org.