The ePOLST initiative is continuing to move forward. Many organizations have completed the intake form for this process. If you have not completed the form, please do so by November 30, 2026.
Everyone,
The ePOLST initiative is continuing to move forward. Many organizations have completed the intake form for this process. If you have not completed the form, please do so by November 30, 2026.
Here is a link to the form:
ABOUT ePOLST:
Massachusetts is transitioning from the existing Medical Orders for Life-Sustaining Treatment (MOLST) process to the National Physician Orders for Life-Sustaining Treatment (POLST) model. This initiative is intended to improve how patients’ preferences regarding life-sustaining medical treatment are documented, communicated, and honored across the healthcare system. The project includes the development and implementation of a statewide electronic POLST registry designed to provide authorized healthcare professionals with access to a patient’s medical orders when they are needed.
For fire-based EMS providers, this initiative is particularly important because EMS personnel are frequently the first healthcare professionals to encounter patients with documented end-of-life care preferences. Under the current system, MOLST forms are generally paper-based and may not always be readily available during an emergency. Forms can be lost, damaged, or unavailable when patients are transported between healthcare facilities or when emergency personnel respond to a residence. The ePOLST registry is intended to address these challenges by providing a more standardized and accessible method of communicating a patient’s treatment preferences.
The new POLST process is expected to provide medical orders addressing a patient’s preferences for resuscitation, intubation, and other life-sustaining interventions. For example, a patient may have documented preferences for Do Not Attempt Resuscitation (DNAR), Do Not Intubate (DNI), limited medical interventions, or comfort-focused treatment. Having access to these orders through an electronic registry may help EMS personnel make informed treatment decisions and ensure that the patient’s documented wishes are appropriately honored. The registry will not replace the Massachusetts EMS Statewide Treatment Protocols, medical control, or existing requirements governing the delivery of emergency medical care.
The current implementation timeline identifies April 6, 2027, as the anticipated statewide go-live date for the Massachusetts ePOLST Registry. Existing MOLST forms are expected to continue to be honored during the transition. As implementation approaches, fire-based EMS departments should begin reviewing their existing policies and procedures addressing MOLST, Comfort Care/DNR, and end-of-life care. Departments should also consider how personnel will access the electronic registry, how POLST orders will be documented in the electronic patient care report, and what procedures will be followed when orders are unavailable, unclear, or potentially conflicting.
Coordination with local hospitals, nursing facilities, hospice providers, and regional EMS partners will also be important to ensure a consistent approach throughout the healthcare system. Departments should monitor additional guidance from the Massachusetts Department of Public Health and the MassPOLST initiative as training, registry access, and implementation requirements are finalized.
The ePOLST project represents an important advancement in ensuring that patients’ treatment preferences are accessible and respected across healthcare settings. For fire-based EMS departments, understanding the operational implications and preparing personnel for the transition will be essential to successful implementation.
Additional information regarding the project and implementation resources is available through the Massachusetts MassPOLST program at https://www.mass.gov/masspolst.
I encourage departments to begin reviewing their existing policies and monitoring the project as Massachusetts moves toward statewide implementation.
Respectfully,
—
Christopher W. Norris, PhD
Fire Chief / Emergency Manager
City of Easthampton, MA