MOLST Transition to POLST

MOLST is a medical order form (similar to a prescription) that relays instructions between health professionals about a patient's care. MOLST is based on an individual's right to accept or refuse medical treatment, including treatments that might extend life.

MOLST is not for everyone.  In Massachusetts, patients with a serious advanced illness at any age may discuss filling out a MOLST form with their clinician.  The patient's decision to use the MOLST form is voluntary.

MOLST is very different from a health care proxy form. All adults aged 18 and older should complete a health care proxy form to name the person who can make medical decisions for them in the event of an unexpected illness or accident. Whenever possible, the Health Care Agent should be included in conversations about MOLST. 

Completion of a MOLST requires discussions between the signing clinician (physician, nurse practitioner or physician assistant), the patient, and family members/trusted advisors about:

• The patient's current medical condition
• What could happen next
• The patient's values and goals for care and
• Possible risks and benefits of treatments that may be offered

After these discussions, the MOLST form is filled out and signed by the clinician to instruct other health professionals about the use of life-sustaining treatments for the patient, based on the patient's own expressed wishes.  The patient signs the MOLST form.

The signed MOLST form stays with the patient and is to be honored by health professionals in any clinical care situation.  Learn more about MOLST by clicking on the links below:

For Providers 

• MOLST Clinician Checklist
• Sample MOLST form and Instructions
• Glossary of terms

For Consumers

• FAQs
  • Spanish - en Español
  • Portuguese - en Portugués
  • Vietnamese - Tiếng Việt
  • Chinese - 繁體中文
  • Haitian Creole - an Kreyòl Ayisyen
  • Russian - Русский
  • Khmer -ភាសាែខ្មរ
  • Cape Verdean – Kriolu di Carbo-Verde
• Sample MOLST form
  • Spanish - en Español
  • Portuguese - en Portugués
  • Vietnamese - Tiếng Việt
  • Chinese - 繁體中文
  • Haitian Creole - an Kreyòl Ayisyen
  • Russian - Русский
  • Khmer -ភាសាែខ្មរ
  • Cape Verdean – Kriolu di Carbo-Verde

For questions about MOLST, email: MassachusettsPOLST@mass.gov

For information about Health Care Proxy, go to Quick Start - Honoring Choices Massachusetts

Massachusetts will be transitioning away from the use of the current MOLST (Medical Orders for Life Sustaining Treatment) form to the National POLST model.

The MOLST form is still valid and should be used to document patients’ wishes until further notice.

Previous POLST test sites should continue to use the POLST in paper format, and should be considered valid by EMS and other healthcare professionals.

POLST is a PROCESS in which:

• Patients are identified by their medical providers as having a serious illness or advancing frailty.
• Conversations take place between a patient and their provider about their medical condition, treatment options and what matters most to them.
• A medical order is completed that reflects the patient’s treatment wishes. The form travels with the patient (Portable Order), and is valid regardless of where the patient is receiving treatment.

After over a decade of using the MOLST form, the Commonwealth is aligning with national standards and best practices, joining dozens of other states using the POLST (portable medical order) form.

Massachusetts will implement an electronic registry (ePOLST) and provide training and program implementation materials as part of the POLST Program. See enabling legislation here. 

Massachusetts will begin the transition with a group of healthcare providers and facilities who have agreed to be Development Partners in a test phase (or pilot). This test phase is tentatively scheduled to begin in late 2024.

Statewide rollout is tentatively scheduled to begin in 2026.

Spearheaded by the Executive Office of Elder Affairs, Massachusetts has engaged experts from most healthcare settings, information technology professionals, and consumers from across the Commonwealth to educate and inform us as we develop our program.

Through a rigorous process, Elder Affairs has selected a vendor who will design, develop and implement an electronic registry that is integrated with most of the Electronic Health Records used in the Commonwealth.

Elder Affairs is working with Development Partners from outpatient, acute, emergency department, EMS, skilled nursing, homecare and hospice to develop best practices and a toolkit for implementation.

There will be testing and training prior to implementation of the electronic registry, supported throughout by technical, quality improvement, change management and clinical experts.

Elder Affairs is also developing regulations and guidance as we test and develop the electronic Registry. The Agency is working with internal and external stakeholders to ensure that there is transparency, communication and collaboration throughout the process.