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Orange Regional Medical Center Integrates eMOLST Access into Epic EMR, Improves Focus on Providing Excellent End-of-life Care

September 1, 2016

(Middletown, NY) – Orange Regional Medical Center has improved its clinicians’ focus on providing excellent end-of-life care by encouraging conversations with seriously ill patients and their family members. Orange Regional recently completed a key milestone in this project by improving providers’ access to the New York State eMOLST Registry. eMOLST allows clinicians to capture patients’ end-of-life orders, and accompanying documentation, to ensure patients’ wishes can be honored at all times and in all care settings.

Orange Regional Medical Center is the first hospital in the Hudson Valley to have this technical integration and the first hospital statewide to have broad clinical implementation of eMOLST.

The Medical Orders for Life-Sustaining Treatment (MOLST) Program helps ensure quality end-of-life care through shared, informed, decision-making conversations between seriously ill patients, their families and healthcare professionals. MOLST orders are documented on the NYSDOH MOLST form and must be signed by a physician. The electronic version, eMOLST, is a secure, web-based system that allows for both MOLST form completion and documentation of the discussion in a centralized database that also serves as New York’s Registry for these documents. eMOLST allows health care professionals to complete the entire MOLST process online and guarantees that the orders and all necessary documentation of the conversation are always accessible.

Orange Regional’s Information Technology (IT) department has taken an extra step to integrate eMOLST into its Epic EMR for easy access by clinicians and other hospital staff. This integration simplifies the login process and search function for providers and allows a patient’s eMOLST orders to be retrieved quickly.

“One of our values is to reduce complexity and risk by simplifying the tools we employ. The integration with eMOLST to our EMR system provides a more efficient way to access critical information and improves the care we provide,” said Orange Regional Medical Center VP, Information technology and Chief Information Officer Brian Tew. “Also, reducing the number of mouse clicks and required log-ins makes everyone happier.”

“We ensure that our patient goals for care and preferences for care and treatment can be honored at any time across the GHVHS,” added Orange Regional Medical Center Administrator of IT Clinical & Business Applications, Dr. Ashok Kumar, MD. “This Single Sign-on (SSO) with patient context integration allows our healthcare providers to complete the eMOLST form and documents seamlessly.”

Orange Regional’s clinical staff, led by Medical Director for the Palliative Medicine, Dr. Emma Fattakhov, is incorporating eMOLST discussions into routine patient care for individuals who are appropriate for these conversations. MOLST orders are only recommended for people who are seriously ill and close to the end of life. MOLST orders must be honored whether the patient is at home, in the hospital, in a nursing home, or in any other setting. eMOLST helps ensure accuracy in MOLST completion and guarantees accessibility to these critical medical orders in an emergency.

“Orange Regional’s focus on eMOLST integration complements its continued commitment to improving multiple aspects of care for patients and their families in the Hudson Valley,” said Medical Director for the Palliative Medicine, Dr. Emma Fattakhov. “eMOLST implementation and further IT integration is in line with the nationally recommended approach for improving end-of-life care as described by the Institute of Medicine in the landmark 2014 report, Dying in America, which cites eMOLST as a best practice for end-of-life discussions and accurate documentation.”

Dr. Pat Bomba, a nationally respected physician leader in end-of-life care and VP & Medical Director for Geriatrics at Excellus BlueCross BlueShield, which operates the NYS eMOLST Registry, stated, “Orange Regional has dedicated more than a year of work to eMOLST implementation to ensure their patients and families are able to have thorough end-of-life discussions and complete eMOLST forms when desired. eMOLST completion ensures their wishes can be honored in all care settings. ORMC is a leader amongst health systems and their approach to eMOLST should be replicated by other organizations.”

More information about the MOLST is available at CompassionAndSupport.org. To learn more about eMOLST, please visit NYSeMOLSTregistry.com.


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