1. POLST Registries: Why, When and How Terri Schmidt MD, MS Professor, Department of Emergency Medicine Director, Oregon POLST Registry February 16, 2012 POLST MOLST MOST POST POLST MOLST MOST POST POLST MOLST MOST POST

2. Why? Frequently (up to 25% of EMS calls) the form cannot initially be found People do not always want their form visible for all to see Schmidt TA, Hickman SE, Tolle SW, Brooks HS: The Physician Orders for Life Sustaining Treatment (POLST) Program: Oregon emergency medical technicians’ practical experiences and attitudes JAGS 2004; 52:1430-34.

3. When? Early in POLST implementation? Once well established?

4. How? Know your state strengths and weaknesses Mandate submission? Education, education, education Call in number? Web-based? Proprietary product? Who owns the Registry?

5. The Oregon POLST Registry Secure electronic registry of POLST orders. Located at the Emergency Communication Center at OHSU Allows EMS, emergency departments and acute care units access to POLST orders 24/7

6. States developing Registies Oregon West Virginia New York Montana Utah Others…

7. How did it happen in Oregon? Piloted the concept at the county level Created and funded by the Oregon legislature in July 2009 Division of duties – State- funds the registry – Center for Ethics – responsible for education and forms

11. Keys to Success Submission mandate Education Responding to the unexpected – ICU access – High ED use

13. Questions? Thank you to Oregon POLST Registry staff