St. Ann’s Is First To Integrate End-of-Life Care Orders Into Electronic Health Records
System Improves Clinicians’ Access to Residents’ Wishes for End-of-Life Care
(November 8, 2016) As part of its commitment to quality care for seniors at every stage of life, St. Ann’s Community encourages seriously ill residents and their families to have conversations about end-of-life care and to document their decisions.
St. Ann’s Community recently made a significant advance in this area by improving health care providers’ access to that documentation so it is easily accessible at all times and in all care settings. St. Ann’s is the first senior-care community in New York State to integrate that information into its electronic health records system.
Ensuring Quality End-of-Life Care
The Medical Orders for Life-Sustaining Treatment (MOLST) program helps ensure quality end-of-life care by documenting decisions about end-of-life care made by seriously ill patients and their families. MOLST orders are documented on the New York State Department of Health MOLST form and must be signed by a physician.
The electronic version, eMOLST, is a secure, web-based system that allows clinicians to access patients’ end-of-life orders from a centralized database. This ensures that patients’ wishes can be honored by all care providers, including emergency medical personnel, and in all care settings, including hospitals, nursing homes, and in the community.
To further improve access, St. Ann’s Community has integrated eMOLST access into its electronic health record systems. Clinicians and other approved staff can log in using their primary St. Ann’s credentials, giving them quick, easy access to residents’ eMOLST orders.
St. Ann’s Community is the first long-term care system in the state to accomplish this integration with the eMOLST registry. It was also the first post-acute health care system to adopt the eMOLST.
“While we’ve had eMOLST implemented for nearly five years, this technical integration improves access to the system for our clinicians,” said David Moufarrege, St. Ann’s Chief Information Officer. “It also adds value for our residents and their families, who know that their orders can be retrieved quickly and efficiently in an emergency situation.”
“The Ultimate Goal”: Honoring Residents’ Wishes
The St. Ann’s Community clinical staff, under the leadership of Chief Medical Officer Dr. Diane Kane, has incorporated eMOLST discussions into routine patient care for all residents for whom those conversations are appropriate.
“Honoring the wishes of older adults regarding medical treatment is an important part of end-of-life care,” said Dr. Kane. “The eMOLST registry ensures there will be shared, informed medical decision-making that reflects the resident’s wishes—which is the ultimate goal.”
Dr. Pat Bomba is a nationally respected physician leader in end-of-life care and Vice President and Medical Director for Geriatrics at Excellus BlueCross BlueShield, which operates the New York State eMOLST Registry.
“St. Ann’s has dedicated five years of work to eMOLST implementation to ensure their residents and families are able to have thorough end-of-life discussions and complete eMOLST forms when desired,” said Dr. Bomba. “Their leadership in the area of end-of-life care has been incredibly valuable for the Rochester community. We would love to see other organizations replicate the approach that St. Ann’s has taken, including the strong emphasis on quality end-of-life discussions and excellent documentation in eMOLST.”
Integration Reflects National Best Practices
eMOLST implementation and technical integration is in line with the nationally recommended approach for improving end-of-life care as described by the Institute of Medicine. The Institute’s landmark 2014 report, Dying in America, cites eMOLST as a best practice for end-of-life discussions and accurate documentation.
St. Ann’s Community has made significant investments in supporting its clinical efforts with technology. In addition to eMOLST integration, it has implemented a single Enterprise Electronic Health Record system across all care settings, disciplines, and locations. The health history of residents and patients follows them throughout the St. Ann’s care continuum and allows staff to provide the best possible care based on a shared view of the whole individual.
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Tom Petronio, Marketing Manager