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  1. Project Scope Statements/Proposals
  2. PSS-1827

POLST Portable Medical Orders CDA IG

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    • Icon: Project Scope Statement Project Scope Statement
    • Resolution: Done
    • Icon: Medium Medium
    • None
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      States have the authority to adopt portable medical order forms for use by patients who are considered to be at risk for a life-threatening clinical event because they have a serious life-limiting medical condition, which may include advanced frailty. All 50 states plus the District of Columbia have adopted such forms or are in the process. These forms vary across states and use different titles. National POLST convened a process among states to create a national consensus form (released in September 2019), but the National POLST Form is not yet available in a standardized electronic format that can integrate into electronic health record (EHR) systems and be updated and shared across care settings and data systems. This lack of information exchange is problematic for seriously ill or frail patients for whom transfers of care are frequent and a POLST may need to be accessed in an emergency. The goal of this project is to close that gap by producing a CDA specification for the consensus form.

      Resources:

      Adoption of National POLST Form: https://polst.org/national-form-adoption-map-pdf

      National POLST Participating Programs: https://polst.org/map-pdf

      Show
      States have the authority to adopt portable medical order forms for use by patients who are considered to be at risk for a life-threatening clinical event because they have a serious life-limiting medical condition, which may include advanced frailty. All 50 states plus the District of Columbia have adopted such forms or are in the process. These forms vary across states and use different titles. National POLST convened a process among states to create a national consensus form (released in September 2019), but the National POLST Form is not yet available in a standardized electronic format that can integrate into electronic health record (EHR) systems and be updated and shared across care settings and data systems. This lack of information exchange is problematic for seriously ill or frail patients for whom transfers of care are frequent and a POLST may need to be accessed in an emergency. The goal of this project is to close that gap by producing a CDA specification for the consensus form. Resources: Adoption of National POLST Form: https://polst.org/national-form-adoption-map-pdf National POLST Participating Programs: https://polst.org/map-pdf
    • Structured Documents
    • Orders & Observations
      Patient Empowerment
    • Orders & Observations
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      Vynca Health
      Cerner
      Beyond Lucid Technologies, Inc.
      Indiana Health Information Exchange
      Image Trend
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      Vynca Health Cerner Beyond Lucid Technologies, Inc. Indiana Health Information Exchange Image Trend
    • Product Family Product Project Intent Lineage Ballot Type Target Cycle Actions
      		1
      CDA
      Implementation Guide
      Create New R1 Standard
       
      STU
      January 2022
    • Hide
      Portable medical order, patient treatment preferences, Clinician Order for Life Sustaining Treatment, COLST, Medical Orders for Life-Sustaining Treatment, Medical Orders for Scope of Treatment, MOLST, MOST, Physician Orders for Life-Sustaining Treatment, Physician Orders for Scope of Treatment, POLST, Portable Orders for Life-Sustaining Treatment, POST, Provider Orders for Life-Sustaining Treatment, Provider Orders for Scope of Treatment, SAPO, SMOST, State Authorized Portable Orders, Summary of Physician Orders for Scope of Treatment, TOPP, TPOPP, Transportable Orders for Patient Preferences, Transportable Physician Orders for Patient Preference
      Show
      Portable medical order, patient treatment preferences, Clinician Order for Life Sustaining Treatment, COLST, Medical Orders for Life-Sustaining Treatment, Medical Orders for Scope of Treatment, MOLST, MOST, Physician Orders for Life-Sustaining Treatment, Physician Orders for Scope of Treatment, POLST, Portable Orders for Life-Sustaining Treatment, POST, Provider Orders for Life-Sustaining Treatment, Provider Orders for Scope of Treatment, SAPO, SMOST, State Authorized Portable Orders, Summary of Physician Orders for Scope of Treatment, TOPP, TPOPP, Transportable Orders for Patient Preferences, Transportable Physician Orders for Patient Preference
    • N/A
    • Yes
    • Yes
    • National POLST
    • No
    • Healthcare IT Vendors, Healthcare Provider/user, Other, Patients, Providers, Standards Development Organizations (SDOs), Vendor/Manufacturer
    • EHR, PHR Vendors, Emergency Services Providers, Health Institutions, state POLST programs, Clinical Decision Support Systems, Registries, HIEs, ACOs, Hospice
    • US

    Description

      Create a CDA R2 IG (US Realm) for the National POLST Portable Medical Orders form, building on the extensive analysis of data elements and stakeholder engagement by National POLST (https://polst.org/). Map POLST data to CDA data elements and terminology and leverage existing or related work, where possible, as well as input from subject matter experts (SMEs). The project scope is limited to POLST data elements and does not include actionable or enforceable medical orders/messages.

      A POLST Portable Medical Order differs from an Advance Directive and from a Personal Advance Care Plan (PACP) in that a POLST form is a portable medical order created by a clinician in consultation with the patient and/or patient's family for patients who are seriously ill or frail. Neither of the two related HL7-published CDA IGs (C-CDA R2.1; Advance Directives Templates & Personal Advance Care Plan (PACP) Document) capture in a single document all the data required for the National POLST Portable Medical Orders form.

      Due to the need for strict adherence to the format and questions on the form, the project team is considering a Model of Use approach.

      Additional information: The term "POLST" has been used by some states to mean "Physician Orders for Life-Sustaining Treatment" or "Portable Orders for Life-Sustaining Treatment" or "Provider Orders for Life-Sustaining Treatment". However, National POLST (the organization that developed the form we are drawing on for this work) defines POLST as a “portable medical order” and no longer uses POLST as an acronym. (See: https://polst.org/history-of-polst/) This project has adopted that approach to the name.

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            Diana Wright Diana Wright
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