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Converting from Paper MOLST to eMOLST? Help Is on the Way!

Upstate nursing homes that would like to adopt eMOLST (the digital version of Medical Orders for Life-Sustaining Treatment (MOLST)) may be eligible for free assistance from Excellus BlueCross BlueShield in converting existing paper forms to the digital format. eMOLST enables electronic completion of the New York State Department of Health (DOH)-5003 MOLST form. It enables each resident's MOLST orders to be accessed 24/7 through the New York State eMOLST Registry regardless of the site of care. Not only does eMOLST facilitate access to life-sustaining treatment orders across the continuum, but it also simplifies the completion of the MOLST form. It uses embedded logic to ensure that all legal requirements are met, to prevent errors, and to avoid inconsistent or incomplete orders. By promoting high-quality MOLST completion, eMOLST increases the likelihood that residents’ MOLST orders will be honored.

Some nursing homes have been deterred from converting from paper MOLST to eMOLST by the time-consuming process of entering data from existing paper MOLST forms to the digital platform. To assist nursing homes with this process, Excellus BlueCross BlueShield is offering ABBYY – a state-of-the-art enterprise tool that can “read” high quality scans of paper MOLST forms and create digital drafts of the eMOLST – free of charge to small and medium-size nursing homes in its service area. After the digital draft is created, clinicians confirm the orders, enter any additional documentation, and re-sign the orders. At the same time, the eMOLST team documents all errors and gaps that need corrections in a report that can be shared with the facility so that clinical staff know where to focus their time. The eMOLST system also points out any gaps in documentation, even when the orders themselves are valid, such as when a concurring capacity determination is missing or when the facility has not documented the clinical standards or conducted an ethics review necessary to support certain types of orders.

According to Excellus, the use of ABBYY with eMOLST takes organizations from paper to eMOLST in a matter of days, instead of weeks. Excellus is looking for additional facilities to work with in transitioning to eMOLST, leveraging the ABBYY technology. Nursing homes that are interested in learning more about eMOLST and ABBYY should contact Katie Orem, MPH, eMOLST Administrator for New York State, here.

In addition to the ABBYY conversion project, Excellus is offering MOLST training resources for health care professionals such as physicians, physician assistants, nurse practitioners, and others who may be involved in MOLST conversations. ECHO MOLST will be offered as an eight-week clinic series in spring 2020. One-hour sessions will be held on Wednesdays at noon, with free CME credits for attendees. Project ECHO is a telementoring model that uses case-based learning. Specialists and experts at a “hub” meet with participants at “spokes” via videoconferencing to support the delivery of specialty care services. More information about ECHO MOLST is available here and through Meg Greco, Excellus Geriatrics and Palliative Care Coordinator, here.

Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8838