If you haven't heard of it, you will and soon.
Iowa Physician Orders for Scope of Treatment is the culmination of a lot of work to help us just do what the patients want!
Easy concept, difficult execution. Enter IDPH. (idph.state.ia.us/IPOST)
Once completed, this document is intended to supplement Durable Power of Attorney for Healthcare and Advance Directives.
Advance directives: iowamedical.org/legal/advancedirectives.cfm, iowabar.org/displaycommon.cfm?an=1&subarticlenbr=152
Durable Power for Health Care: iowabar.org/displaycommon.cfm?an=1&subarticlenbr=154,
The gap filled by this process, represented by the completed form, is to give us a clearer idea of the patient's wishes regarding care at the end of life. Currently, nearly everyone says they want to die at home, surrounded by family and familiarity. Currently, nearly everyone dies in a hospital or care facility, often in discomfort. (To be clear, the discomfort and lack of adherence to wishes is not from bad people, it's from a system that does not make clear the patient's wishes at such time as these wishes are needed to be known.)
There is a group working on supporting you in the community helping people understand how to use these tools. Currently, the Nursing homes, Hospitals and Cancer Center have committed staff to train as facilitators. Obviously, more will be needed. Churches and places of worship could be a major resource by getting people trained and making workshops available. Through WMS/IMS, I am representing you to this committee.
As this movement takes hold, people will be showing up in your offices with a salmon colored form on heavy (card stock) paper for you to sign. Often, they will have completed it. You may sign as their physician or a PA or NP working with you may sign. The original belongs to the patient. The law provides that a copy, electronic or paper, is as valid as the original.
Notes of interest (page numbers refer to HF2165 "The law", below:
*IPOST is valid for children.
*IPOST from another state (with a different name, of course) is valid in Iowa. (p.3)
*IPOST orders do not require admission privileges. (p.4)
*There is an absolute defense provision for following these orders. (p.4)
*IPOST orders can be withdraw any time, just as advance directives may be. (p.4)
The law: idph.state.ia.us/IDPHChannelsService/file.ashx?file=7AF228E8-6289-4327-8126-701A6DBD2BE2
For you review, a presentation from IDPH: idph.state.ia.us/IDPHChannelsService/file.ashx?file=3BB49754-0A70-472E-86B4-8BB708801EA7
An excellent toolkit is available from Iowa Healthcare Collaborative: ihconline.org/UserDocs/Pages/IPOST_Portfolio.pdf
Look for information and press releases in the next few weeks. This will be a winning project going forward. Get to me with questions and concerns; they'll be addressed here.