Panel removes instruction that receiving provider must contact signing provider from POLST form

Department of Public Health meeting — February

At a February Department of Public Health meeting, staff reported they will remove a line in the draft medical orders (POLST-style) form that told a receiving provider to follow orders and then contact the physician or other provider who signed the form. The change was recommended after a legal review found the contact requirement did not appear in the policies and could interfere with clinical practice.

The revision emerged during a staff update from Dante, a policy staff member, who said the form and the written policies must match. “Part of our legal review has been ensuring that there’s…full consistency between the policies and procedures and the form,” Dante said during the meeting.

Why it matters

Committee members said the contact requirement could create a barrier to access and an undue constraint on clinicians acting in urgent or transitional care settings. Dr. Shapiro, a palliative care clinician on the call, described typical workflows in which hospital-based clinicians or palliative consultants complete the form and have limited continuity with EMS or field providers: “Most of the people completing the form are people like me who are the palliative care consultant and hearing from anyone on the EMS side would really provide no benefit to me or the patient because there isn’t a lot of continuity of care,” Dr. Shapiro said.

Discussion and next steps

Members suggested the sentence be deleted so the form does not impose requirements that are not in the written policies. Dante confirmed the change under discussion is limited to removing the second line of the instructions that required contacting the signing provider; doing so would not prevent voluntary communications between providers. Dante told the group the draft will continue through the internal policy review and then to the commissioner for final review. He estimated a realistic approval timeline of three to four months before the form could be published with accompanying training.

Training and implementation timing also figured in the discussion. Committee members emphasized coordinating the digital form’s publication with provider training so clinicians learn the updated workflow and do not face a new form without instruction.

The meeting did not take a formal vote specifically on the form language; the staff update concluded with agreement among members to pursue the deletion and to move the draft forward through the policy review process.