Following a successful pilot in 2018, all of VNSNY Hospice’s clinical teams have now begun employing the electronic version of New York State’s Medical Orders for Life-Sustaining Treatment. Known as eMOLST, it was created by a New York physician and is the most comprehensive set of portable medical orders for life-sustaining treatment ever approved by the state’s Department of Health.
Since late January of 2019, VNSNY Hospice has been using eMOLST throughout its New York City service area—making it the only large urban hospice program in New York State to be utilizing the digital end-of-life directive, which gives clarity and peace of mind to patients, families, and clinicians.
“Early on, we decided we’d use the electronic form of MOLST exclusively, rather than the paper version,” explains Rivkah Brenenson, Quality Improvement Manager for VNSNY Hospice. “The eMOLST has a number of advantages: An individual’s eMOLST document can be accessed in any setting through a secure online portal, so the patient’s wishes are always known to medical professionals. And the eMOLST also has automatic prompts that guide you when you’re filling it out, ensuring that each form is properly completed.”
The ability to use eMOLST in different settings will become increasingly seamless as more of the state’s medical centers adopt the online directive, adds Brenenson. “For example, NYU Langone Health System is using eMOLST, and we’re partnering closely with their staff on training and information-sharing.”
VNSNY will be tracking patient outcomes to see whether use of the eMOLST reduces unwanted hospitalizations, notes Bonnie Lauder, Director of Quality Management Services. “In addition, we’re finding that discussions around the eMOLST are offering a new way for clinicians to open up the conversation about a person’s end-of-life wishes in general,” she says. “It’s really a wonderful tool.”
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