Medical Orders for Life Sustaining Treatment (MOLST) to Physician Orders for Life Sustaining Treatment (POLST) Transition

The primary impetus for the MOLST to POLST transition is challenges with the current form and process. Stakeholders identified the lack of an electronic form, no interoperability with electronic health record systems, and lack of alignment with evidence-based best practices as the significant limitations with MOLST.

As part of the transition, Massachusetts will be introducing an electronic POLST (ePOLST) registry. The ePOLST registry will be a true bidirectional exchange, with the ability to submit and retrieve documents. As part of the project, the Commonwealth will also be introducing a new standardized form. The POLST form is an evidence-based, advanced care planning document that is aligned with the National POLST Paradigm. 

In addition, the initiative will emphasize working with and training Massachusetts providers in evidence-based, serious illness conversation training. The POLST transition is more than implementing a registry and a form change, it is a change of behavior.

At the end of the day, the POLST rollout is an initiative geared around ensuring that patients’ needs and desires are met during serious illness and end of life care. Many States across the country have statewide use or are working towards statewide use of the POLST form. (National POLST: POLST Use by State). 

Where are we currently in the POLST transition?

As of Spring 2025, the project has kicked off early piloting of the ePOLST registry. 

For more information, you can subscribe to updates here. You may also contact MassPOLST@mass.gov to learn more about the statewide POLST initiative.