Compassion and Support
DECEMBER 2016
eMOLST Enhancements in 2016

By Katie Orem, MPH, eMOLST Administrator

In 2016 we deployed many key updates to the eMOLST application available at NYSeMOLSTregistry.com. Several were improvements based on user experience and requests. We are thrilled to continually improve eMOLST based on our users' feedback. Some of the most-requested improvements that were made in 2016 include:

1. Patient Context EMR Integration. In 2016 we deployed the ability for eMOLST to accept key patient demographics from external data sources, such as EMRs. Our users love it. This integration allows for single click search from an EMR so that the provider doesn’t have to remember an eMOLST username or password and they also automatically search for the patient that’s currently open in the EMR. This deeper integration, which we call “Single Sign On + Patient Context,” also reduces keying errors and makes it easier & faster to both create and retrieve patients. Health systems can read about SSO + Patient Context in our integration guide.

2. Data Analysis Capabilities. eMOLST users have always wanted an analytics tool integrated with the system. The first major step towards eMOLST analytics was accomplished in 2016 with a dramatic enhancement in the data layer processing speed. This was a necessary step to ensure the raw data can be quickly and efficiently organized. In 2017 we will prioritize implementation of a sophisticated analytics tool to allow for useful visualizations of the raw data.

3. Better administrative tools. In 2016 we made many administrative improvements. A few highlights include: creating a tool to bulk import patients with paper MOLST forms; improvements to the user creation tool which allows us to more efficiently enroll, update and disenroll users; development of a tool to help organizations quickly identify patients in need of review along with the providers who are responsible for those patients; and significantly improved logging.

4. API. Trusted health systems, HIEs and RHIOs have asked for the ability to make a web services call to eMOLST to ask key questions, such as “does this patient have a form?” and “can I see a copy of it?” as well as more detailed requests. In 2016 we launched an API that will allow trusted organizations to efficiently answer these questions and more. This is a brand new tool and we look forward to assisting health systems in adopting this technology in 2017.

If you're a current user with questions or a suggestion, or are interested in getting started with eMOLST, please email Patricia.Bomba@lifethc.com and Katie.Orem@excellus.com

For more information, please visit NYSeMOLSTregistry.com. Thank you for your continued use and support of eMOLST!

Featured Resource: Get Paid for MOLST Discussions

Key barriers for physician engagement in thoughtful MOLST discussions include, lack of time, lack of reimbursement for time and the need for advance care planning training to improve knowledge, attitudes and communication skills. In January 2016, the Center for Medicare Services (CMS) approved two new CPT Codes 99497 and 99498 to allow physicians and “other qualified health care professionals,” to be reimbursed for having an advance care planning conversation with their Medicare patients. Learn more on how to properly use the ACP CPT codes.

MOLST FAQ: Can Telemedicine Be Used to Provide and Bill for Advance Care Planning Services?

Yes. It is included in the 2017 CMS Physician Fee Schedule, effective 1/1/2017. In 2016, the service must be face-to-face with the patient, family member(s) or surrogate(s), except in accordance with NYS regulations, for new or renewing commercial policies, on or after 1/1/2016, Health Plans must cover services provided by telemedicine that would be covered if delivered Face-to-face.


eMOLST Champion: John T. Mather Memorial Hospital

Pictured Left to Right: Richard Poveromo, LMSW, Director of Social Work, John T. Mather Memorial Hospital, Patricia A. Bomba, MD, MACP, Lisa Volpe & Jacob Joseph, BSN. photo credit: Carolyn Kazdan

John T. Mather Memorial Hospital was the first not-for-profit community hospital in the Town of Brookhaven and they are now on a trajectory to become the first hospital on Long Island to implement eMOLST. Mather is located on a 35 acre campus in Port Jefferson where 2568 employees and more than 600 affiliated and employed physicians see more than 41,000 emergency room cases and 12,000 inpatients annually.

A team of 6 Mather hospital leaders attended the IPRO CMS Special Innovation Project on Transforming End of Life Care Kick-Off in January and then began their journey to eMOLST implementation using a team approach. Social Work Director, Richard Poveromo, LMSW has played a key role in implementation, inviting Dr. Bomba to Mather Hospital in April to meet with and provide education for the hospital’s Palliative Care Team. Mather Hospital clinicians and authorized users are initially accessing the eMOLST registry via a hyperlink from their EMR while they partner with the eMOLST team and EMR Allscripts Sunrise Clinical Manager to incorporate Single Sign On.

As part of their community approach to implementing eMOSLT, Mr. Poveromo worked closely with IPRO Quality Improvement Specialist Carolyn Kazdan, MHA, NHA to develop and host a one day conference in October on Improving End of Life Care for over 50 healthcare, agency and legal professionals in the region who serve patients and clients with special needs. Dr. Bomba was the keynote speaker and panel facilitator for the dynamic day of learning and case study discussion.

IPRO’s CMS Special Innovation Project on Transforming End of Life Care on Long Island: A Year in Review

By Carolyn Kazdan, MHSA, NHA

2016 was an exciting first year for the Transforming End of Life Care Special Innovation Project which has been working to educate Medicare beneficiaries and caregivers in Nassau and Suffolk counties on the importance of Advance Care Planning, educating healthcare providers on MOLST and eMOLST and providing technical and educational support to healthcare providers implementing eMOLST. Through a series of 55 community and professional association based educational programs, DSRIP SNF partner meetings, webinars, and facility visits, project partners Patricia A. Bomba, MD, MACP and eMOLST Administrator Katie Orem, MPH have partnered with the IPRO team to train over 1,000 healthcare professionals with 10 healthcare providers now using and/or in the process of implementing eMOLST and multiple additional providers actively engaged in reviewing eMOLST Participation Agreements with a goal of implementation in 2017.

On the Medicare consumer side, Dr. Bomba, Patient Advocate Beth van Bladel, CPA, CSSGB and The Gitenstein Institute for Health Law and Policy at the Maurice A. Deane School of Law at Hofstra University and the North Shore-LIJ Health System CHAT (Conversations: Health and Treatment) program have conducted a combined total of 27 Beneficiary/Caregiver outreach educational sessions, educating over 500 seniors and caregivers throughout Nassau and Suffolk County. These sessions in English and some utilizing materials in Spanish with a Spanish translator have been held at a variety of forums including multiple low income senior housing sites, Assisted Living Communities, a Retirement Community, LGBT Seniors meetings, the YMCA/JCC Senior Center and the Long Island Alzheimer’s Association Annual Caregiver Conference. At every forum we have found that many more seniors have completed health care proxy forms than have actually had a robust discussion about their wishes with their health care agent and/or their physician and so the project will continue to focus on how to remove barriers and complete the 5 Easy Steps to Advance Care Planning as found on CompassionAndSupport.org.

Social Media postings on Facebook and Twitter have also been utilized to reach the broader community, along with radio interviews conducted with Dr. Bomba on NPR’s Suffolk County radio Station and the Nassau County based Project for Independence Radio Show “Project Independence And You”.

Plans for year 2 of the project are underway and ideas are always welcome and can be submitted to IPRO Quality Improvement Specialist at Carolyn.Kazdan@area-I.hcqis.org

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