Blue Cross Contribution Jumpstarts Funding for Massachusetts Online Registry for Health Care Decision Medical Orders

Clinicians will have immediate access to patients' documented preferences for life-sustaining treatment

Mar 23, 2021
Blue Cross Contribution Jumpstarts Funding for Massachusetts Online Registry for Health Care Decision Medical Orders

Massachusetts is building a state electronic registry to allow clinicians timely and trusted access to the medical forms that document patients' preferences for care near the end of life, thanks to contributions from Blue Cross Blue Shield of Massachusetts ("Blue Cross") and the Massachusetts Coalition for Serious Illness Care (" the Coalition").

"This electronic registry – a trusted, single source of truth - is a critical part of ensuring that everyone in Massachusetts receives care that supports their priorities," said Andrew Dreyfus, president and CEO of Blue Cross Blue Shield of Massachusetts and founding member of the Massachusetts Coalition for Serious Illness Care. "Far too often, people don't get the care they want. It was clear there was a huge opportunity to improve this part of the health care infrastructure so that clinicians all over the state can quickly access patients' documented preferences for their care when it matters most."

The registry will include forms called physician orders for life-sustaining treatment, or POLST. Contributions from Blue Cross and the Coalition helped the Massachusetts Executive Office of Health and Human Services secure matching funding for the registry from the Centers for Medicare and Medicaid Services.

"With the support of Blue Cross and the Coalition for Serious Illness Care, it's public-private partnerships like these that advance key policies and the quality of health care across the Commonwealth. This important initiative will promote compassionate end-of-life care for Massachusetts residents" said Lauren Peters, Undersecretary at the Executive Office of Health and Human Services.

POLST programs across the country offer people with serious, life-limiting illnesses a unique and powerful way express their wishes for care near the end of life. But these vitally important documents are too often poorly filled out, difficult to locate, or ignored in the moment due to concerns over validity. Studies on Massachusetts' current program, called MOLST, have highlighted how challenging it is for these orders to follow a patient across different health care settings; how often they include conflicting or incompatible choices; and how often they are completed without a high-quality conversation about what truly matters to patients and their families.

Massachusetts will join a handful of other states, including California, New York, and Oregon, that have introduced such registries to help ensure that residents' preferences are honored at the end of life.

As part of the project, the state will update its POLST form to align with national standards and conduct extensive outreach and education about the new form and how to use the online registry.

Stakeholder engagement and planning is underway in partnership with the Coalition's MOLST-to-POLST Advisory Group, which includes representatives from Ariadne Labs, Honoring Choices Massachusetts, The Massachusetts Health & Hospital Association, The Hospice and Palliative Care Federation of Massachusetts, Massachusetts Medical Society, and UMass Memorial Health Care. A series of listening sessions and feedback opportunities will be announced shortly.

"This is a huge gift to the people of Massachusetts," said Erik Fromme, senior scientist and faculty lead of the Serious Illness Care Program at Ariadne Labs. "An e-registry can catalyze major improvement in our ability to honor patients' preferences when they are seriously ill. It's a powerful tool to support first responders and ensure that patients get the right care no matter where they are."

"We appreciate the visionary leadership of BCBSMA and this generous gift to help revitalize our serious illness program and support a new POLST form and ePOLST registry," said Ellen DiPaola, president of Honoring Choices Massachusetts.

"This is a great breakthrough in an area of health care that is important to every patient and family member in the Commonwealth," said Lachlan Forrow, a Coalition Advisory Group member who co-chaired the Commonwealth's earlier Expert Panel on End-of-Life Care.

Last year, the MSCIC announced the launch of a temporary eMOLST web portal to aid in virtual conversations and document completion, so critically important – and challenging – during the COVID-19 pandemic. The portal, created in partnership with Ariadne Labs, Honoring Choices Massachusetts and Vynca, embeds communication tools and resources.

"Through this collaboration, we've learned so much about what our state needs from a new approach to POLST. And those lessons will set us up for success as the state begins its much broader work," said Anna Gosline, executive director of the Massachusetts Coalition for Serious Illness Care. "Together, these efforts all highlight the power of partnerships. Our Coalition brings together a diverse group of organizations, communities, and individuals across the state, allowing us to move quickly when needed, while investing the long-term, systemic changes that are required to ensure high quality, person-centered care for everyone facing a serious illness."

About Blue Cross Blue Shield of Massachusetts
Blue Cross Blue Shield of Massachusetts (bluecrossma.com) is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We are committed to the relentless pursuit of quality, affordable and equitable health care with an unparalleled consumer experience. Consistent with our promise to always put our members first, we are rated among the nation's best health plans for member satisfaction and quality. Connect with us on Facebook, Twitter, YouTube, and LinkedIn.

About the Massachusetts Coalition for Serious Illness Care
The Massachusetts Coalition for Serious Illness Care was founded in 2016 by Ariadne Labs, Blue Cross Blue Shield of Massachusetts, and The Conversation Project. Today, more than 120 organizations across the Commonwealth come together through convenings, research, focused initiatives and dedicated working groups to advance the vision of ensuring that all people receive health care that supports what matters most throughout our lives, especially when we're seriously ill.

SOURCE Blue Cross Blue Shield of Massachusetts