EMS Data: Integration with Electronic Medical Records. Greg Mears, MD NC EMS Medical Director EMS Performance Improvement Center

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Meredith Stone
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1 EMS Data: Integration with Electronic Medical Records Greg Mears, MD NC EMS Medical Director EMS Performance Improvement Center

2 EMS Data: Can t Live With It, Can t Live Without It

3 EMS Data: Lessons Learned from 3 State Implementations

4 EMS Data: What They Didn t Bother to Tell You

5 Sitting Ducks Is EMS Health Care? Paperwork vs. Medical Record Little Expertise in IT/Computers/Typpping Belief in the Importance of Data Trusting Nature Marginal Front Line Motivation Ability to Write Very Large Checks Typically Only Once

Belief in the Importance of Data Trusting Nature Marginal

6 Eyes are Bigger Than or Brain Try to collect too much information before we show value More than the National Elements Less than a lynch mob Focus on Data Collection with No Plan for Data Application It is not our nature to believe we are not providing the best possible service and care

mob Focus on Data Collection with No Plan for Data Application It is

7 Were From the Government and We are Here to NEMSIS Data Standard Data Transmission Standard The Myth All I have to do is pick a NEMSIS Gold Compliant Software and we are good to go.

8 The Truth Shall Set You Free: Sort of.. Once you have seen 35 NEMSIS Gold Compliant Software Products. you have seen 35 different implementations of NEMSIS Being presented with the ability to collect standardized data does not mean. All the data elements will be collected The data collected will be accurate The data will every be sent to the State EMS Data System

you have seen 35 different implementations of NEMSIS Being presented with the ability to

9 Keys to Finding Quality Software Understand that Software Vendors are not in this business for the same reason you are Start with NEMSIS Gold Compliance Add Business Logic Can t Leave the Scene before you arrive If it is a Trauma you must document the injury mechanism If the EMS Disposition is Transported by EMS, there needs to be a patient Test the data submission file after the software is installed locally

you arrive If it is a Trauma you must document the injury mechanism If the EMS Disposition is

10 NEMSIS Version 3: The Future Standardized Data Definitions Standardized Data Transmission (XSD) Required Business Logic Validation before Record is Finalized by User Required Automated Data Transmission HL7 Compatibility CAD, Medical Device, Billing Data Feeds

Validation before Record is Finalized by User Required Automated

11 Now You Have A Data System? Hospitals are Not Getting A Copy of the PCR? I can t get anyone to look at the data How is this improving Service Delivery or Outcomes Everyone wants me to answer their questions The Press just called. What is Insert Name Here EMS Agencies Response Time This is not what I expected

or Outcomes Everyone wants me to answer their questions The Press just called.

12 Hospitals and EMS PCRs EMS is responsible to provide written documentation of patient care to the next healthcare provider in the episode of care Hospitals are able and responsible to provide outcome information on patients they receive from EMS HIPAA has NOTHING to do with it.

episode of care Hospitals are able and responsible to provide outcome

13 Ways to Provide Hospitals PCRs At the Time of Patient Hand-off Printed copy prior to leaving the Emergency Department Hand-Off Form pending PCR completion Permanent Medical Record Printed or Electronic copy of the Final PCR Access to Hospitals to download PCR

Form pending PCR completion Permanent Medical Record Printed or

15 I Can t Get Anyone To Look at Their Data Immature Data Systems Benchmarking Peer Pressure Integrate Operations and Protocols Mature Data Systems Benchmarking Performance Improvement Peer Review Transparency

Operations and Protocols Mature Data Systems

17 Protocol Driven Performance Measures Performance Measures Performance Improvement Peer Review Dispatch Center Times % Scene Times < 15 minutes Review of insert Events Scene Times % ASA Administration Documentation Review Airway Success % of Responses with FR Skills Chosen Correctly Delays % of Patients VS Documented Protocol Compliance Vehicle Failures % PCR s without a Protocol Repeat Patients <48 hours ASA Administration Pain Control with Pain Score >6 Review of Deaths Destination Choice Time to Defibrillation First Responder on Scene Vital Sign Documentation Protocol Documented Pain Score

Patients VS Documented Protocol Compliance Vehicle Failures % PCR s without a Protocol Repeat Patients <48 hours ASA Administration Pain Control with

19 Peer Review

20 News and Observer Line 1 Protect the Data State Requirement for Data Release is NOT FOIA or Is it? Peer Review Protection Data Release Policy/Procedure To What Level? Patient EMS Agency? Transparency

21 A Link to the Future Why Regionalization Outcomes Evidence Based Medicine How Should it Work Connect all aspects of a patient event Provide outcome information up-stream to EMS and Community Hospitals Allow the dials to be adjusted for performance

South Carolina EMS Data System Frequently Asked Questions (FAQs)

South Carolina EMS Data System Frequently Asked Questions (FAQs) Data Submission and Participation Questions 1. Is the SC EMS Data System based on the old DHEC Form that has been in place the last several