Life Matters Media
Quality of life at the end of life

New Jersey Moves Toward Electronic POLST System


New Jersey could soon become one of the first states to use a state-wide electronic health registry to store seriously ill patients’ medical orders.

State Health Commissioner Cathleen Bennett and officials from the New Jersey Hospital Association unveiled the new electronic Practitioner Orders for Life-Sustaining Treatment (POLST) initiative this month at a local hospice.

Electronic POLST (ePOLST) is designed to be a fully integrated electronic version of the paper form, which would still be honored.

POLST forms are far more detailed than conventional living wills or advance health care directives – these medical orders extend patients the freedom to indicate preferences regarding hospitalization, resuscitation, intravenous antibiotics and duration of feeding tubes.

With an electronic registry, patients and health care providers would be able access such forms online via a secure website and mobile devices.

As part of the ePOLST initiative, a central repository for POLST would be created electronically, enabling access for health care professionals — including EMS — across the state. The hope is that patients in their last months of life will have their wishes honored, no matter the location of care.

“Creating electronic access to the POLST form will help ensure patients’ wishes are honored,” Bennett said in a statement. The program is still be tested.

“Through this tool, more health care providers will have immediate access to critical information they need to treat the patient according to the patients’ healthcare preference. Patients with smart phones also will be able to share their electronic POLST form with a new physician, specialist or emergency room doctor.”

Gov. Chris Christie signed New Jersey’s POLST law in 2011. The state designated the New Jersey Hospital Association to create New Jersey’s POLST form.

The POLST program was developed in Oregon the 1990s to help ensure the wishes of terminally ill patients nearing death are followed by physicians and emergency responders. POLST programs have since been adopted or are in development in most of the nation, as well as in a handful of countries.

In Oregon, more than a quarter million POLST forms have been submitted to the registry since its inception in 2009, according to data compiled by Oregon POLST. More than 5,000 health care professionals have called the registry seeking forms.

A 2014 study co-authored by Tolle and published in the Journal of the American Geriatrics Society found that patients with POLST forms are highly likely to have their wishes honored.