OHSU develops instant, computerized notification system to communicate patients' end-of-life wishes

PORTLAND, Ore. Physicians at Oregon Health & Science University have developed a new system to alert clinicians of an OHSU patient's end-of-life wishes upon arrival at OHSU Hospital. The system is part of OHSU's secure electronic medical records database and provides clinicians with near-immediate information when a patient's doctor has filled out a Physicians Orders for Life-Sustaining Treatment (POLST) form or the patient has an advanced directive.

"In light of national media events, patients more often ask, 'How can I be sure my wishes will be followed?'" said Susan Tolle, M.D., director of the OHSU Center for Ethics in Health Care. "They are pleased to learn that their advance directive or POLST form can be scanned into the electronic record system. This means that a reminder will pop up on the OHSU computer screen to alert any future health professional who cares for them of the existence of these important documents."

The POLST program was originated in Oregon. It allows chronically ill patients to direct their end-of-life care by discussing a detailed care plan that is signed by their physician. POLST forms provide specific health care directives about treatments that are wanted and those that are not. If a chronically ill patient enters the hospital and is incapacitated, an alert screen notifies the medical team of the POLST and directs them how to react. For example, a patient with advanced lung disease may want to be hospitalized with pneumonia, but may not want to be placed on a breathing machine in the intensive care unit. Doctors need to know this immediately to respect the patient's wishes the minute he or she arrives at the hospital.

Along with the POLST form, OHSU patients also have their advance directives filed electronically with their medical records. This service is valuable for healthy adults who suffer from sudden illness or traumatic injury -- in these cases, initially, all emergency medical treatments are provided.

Contact: Jim Newman
Oregon Health & Science University

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