POLST eRegistry Pilot Project

Investigator: Stuart Heard, PharmD
Sponsor: Coalition for Compassionate Care of CA

Location(s): United States


Physician Orders for Life‐Sustaining Treatment (POLST) is a standardized medical order form that indicates which specific treatments, such as a ventilator or feeding tube, a seriously ill patient does or does not want. Unlike a health care directive, a POLST form is signed by the patient and physician and is intended to serve as medical orders that move with the patient across settings of care.

In 2015, the Coalition for Compassionate Care of California sponsored two POLST-related bills and both were signed by Governor Jerry Brown. AB 637 (Campos) allows nurse practitioners and physician assistants – under the supervision of a physician and within their scope of practice – to sign POLST forms and make them actionable medical orders. SB 19 (Wolk) requires the State to establish and operate a statewide digital registry for the purpose of collecting POLST forms received from health care providers.

In September 2016, CHCF launched a POLST eRegistry pilot in California, in collaboration with EMSA and the Coalition for Compassionate Care of California. The pilot is testing the development and implementation of POLST eRegistries in two community settings, the City of San Diego and Contra Costa County. These registries will enable the submission, storage, and retrieval of POLST forms across participating care settings with the goal of demonstrating feasibility, functionality, quality, and acceptability of the registries to inform and support the development of statewide electronic access to POLST.

Each pilot site has committed community and technology partners:

  • Contra Costa County: Alameda-Contra Costa Medical Association and Vynca
  • City of San Diego: San Diego Health Connect and Stella Technology

Additional project partners include California Poison Control, which will serve as a back-up call center for emergency medical services personnel, and an evaluation team from Oregon Health and Sciences University and the Public Health Institute.