Yale team urges electronic MOLST to improve access and reduce errors

A Yale team presented a policy brief to the MOLST Advisory Council proposing an electronic version of the Medical Orders for Life‑Sustaining Treatment (MOLST) form to improve access and reduce treatment errors. Michael Warner, lead aging policy analyst at the Connecticut General Assembly—s Commission on Women, Children, Seniors, Equity and Opportunity, said the project grew from clinician conversations this spring and a student research collaboration over the summer.

Victoria, a Yale master's student working on the brief, told the council that an electronic MOLST would make a patient—s orders immediately accessible across hospital systems and long‑term care settings, reduce documentation errors and clinician administrative burden, and improve coordination and equity for underserved populations. She said New York and Oregon provided working examples of statewide electronic orders that increased provider participation and patient‑safety outcomes.

Rachel, a postdoctoral researcher at Yale School of Medicine who has studied surrogate decision makers and end‑of‑life planning, described the project as a student‑driven policy brief that engaged nursing homes and other long‑term‑care providers during its research phase. Michael Warner said the brief is being updated with additional analysis and could be shared later with the council.

Council members pressed the presenters on utilization figures and practical barriers. Several clinicians on the call said training exists but is underused in some large health systems, and the presenters acknowledged variability across provider types and settings. Barbara Cass, senior adviser for long‑term care at the Connecticut Department of Public Health (DPH), told the group that a previously circulated figure of roughly 500 trained providers dated to an earlier system that lacked integration with Connecticut—s registration systems and should not be taken as a current utilization benchmark.

Presenters and council members also discussed implementation risks and safeguards. The students— brief suggested eMOLST could reduce unwanted and unnecessary treatments by making the most recent medical orders easier to find; presenters said legislative or administrative steps would be required to standardize submission, access and data governance. The Yale team said they will continue work on the brief and offered to share further comparative research on state implementations.

The council did not take formal action on the brief at the meeting; members encouraged further collaboration between the students, the commission and DPH staff.