AUGUSTA — Can lessons from methods used by health officials to consult patients during the COVID crisis be used to improve end-of-life care conversations with patients wherever they live, regardless of their physical access to healthcare? The National POLST and Maine Hospice Council and Center for End-of-Life Care believe the answer is yes. Thanks to a Rita and Alex Hillman Foundation grant the two groups have a chance to prove it.

POLST is many things — a process, a conversation, and a medical order form for individuals who are seriously ill or have advanced frailty. It is an important part of advance care planning that includes thoughtful discussions between a patient and their provider about their medical condition, treatment options and wishes. It is also a medical order form that travels with you (called a POLST form). 

National POLST Executive Director Amy Vandenbroucke, JD described this new project as having two key components: National POLST partnering with the Maine POLST Program, focusing on three rural communities for testing models and working with national partners to conduct surveys and compile successful strategies for legislative change to share. 

National POLST and the Maine Hospice Council have a strong working relationship. The new project will rely on Maine’s substantive POLST network, including its nurse practitioners, physicians assistants, and the use of telehealth. The goal? Use the Maine findings to develop consistent policies for POLST Programs nationwide to save time, eliminate travel barriers for patients/providers, and enable more people the chance to have high-quality POLST conversations. 

The Maine initiative will focus on rural areas with varying levels of POLST utilization: Greater Blue Hill/Ellsworth area (Hancock County), Greenville (Piscataquis County),and Jackman (Somerset County). The two main partner groups will also be working with other partners. The

network of Federally Qualified Health Centers (FQHCs) serves individuals in some of our most rural areas. And the VA Health Care System has a well-developed tele-medicine infrastructure that offers access for patients in remote areas. 

Maine Hospice Council Executive Director Kandyce Powell, MSN, RN said, ”The Maine Hospice Council is honored to have been invited to partner with National POLST on this ambitious grant. We are grateful to the Alex and Rita Hillman Foundation for realizing that individuals and families in rural regions deserve the same access to healthcare conversations and services as individuals in more urban areas. The use of telehealth during the pandemic proved to be immeasurably valuable during a time of crisis. One of many lessons learned that may continue to increase access in the future.”