On March 20, 2020, a new law called the Electronic Medical Order for Scope of Treatment Registry Amendment Act of 2019 was enacted in DC. This law allows for the establishment of an electronic MOST (eMOST) format, which uses cloud-based technology to facilitate the use of Medical Orders for Scope of Treatment (MOST) Forms. These forms can be accessed and shared with healthcare providers through the State-designated health information exchange. The electronic MOST form empowers terminally-ill patients to make decisions about their end-of-life care in consultation with their DC-licensed healthcare provider. This initiative is a partnership between DC Health and the DC Department of Healthcare Finance, using solutions developed by A|D Vault, Inc.

The administration of the MOST program falls under the DC Health EMS Program. As part of the implementation plan, an advisory committee has been established to assist in the development of the MOST form and raise public awareness.

 

To facilitate the use of the eMOST form, the DC Department of Health Care Finance, DC Health, and CRISP DC have collaborated with A|D Vault to embed its advance care planning platform called MyDirectives in the health information exchange. This cloud system allows healthcare providers and any CRISP DC HIE user to create, upload, and view advance care plans, including the eMOST form, from anywhere and at any time. This ensures that all care teams, including ambulatory providers and DC Fire and EMS responders, have access to the patient's most up-to-date care decisions for future, urgent, and end-of-life planning.

 

Users also have the option to scan and upload existing advance care planning documents, such as paper DC MOST forms, through the A|D Vault website. To learn more about accessing MyDirectives for Clinicians in CRISP and to begin the onboarding process, healthcare providers can contact the CRISP DC team at [email protected].