Effective implementation of the MOLST program requires a multidimensional approach that begins with culture change.  Well informed shared decision making requires professional training of physicians, nurse practitioners, clinicians & other professionals as well as public education, engagement & empowerment on advance care planning, advance directives and MOLST.  A key goal of is to foster thoughtful MOLST discussions, well informed shared medical decision-making and care planning that supports patient preferences for care and treatment as documented on MOLST.

Importantly, practice transformation requires dedicated physician and system champions who work to effect system implementation in different settings and develop policies and procedures that align with needed changes in workflow to allow adequate time for these important discussions. Leveraging existing payment streams, such as CPT codes 99497 and 99498 encourages shared decision making.  Aligning efforts with health system quality and patient safety initiatives provides an opportunity to ensure seamless care transitions throughout the community.

New York’s eMOLST is an important tool that combines a standardized interoperable online completion and retrieval system available in all care settings to ensure 100% accuracy and accessibility. An additional array of tools and resources are available for hospitals, nursing homes and primary care and multispecialty practices who are digitally transforming from paper MOLST to eMOLST.

The clinic series ECHO MOLST was established in 2018 to provide professional training on MOLST, eMOLST, and advance care planning. Clinicians or anyone involved or interested in the MOLST process is welcome to join the biannual webinar series to enhance their knowledge and confidence in adhering to patient preferences at end-of-life.

Research and References pertinent to New York’s MOLST program are supported by additional national Research and References on If you wish to share pertinent resources, contact us.

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The MOLST Update is a Newsletter dedicated to providing up-to-date information on advance care planning, MOLST and eMOLST.