Basic Facts and Comparisons Between Service Bridge, Field Bridge and Field Bridge Express Reference for EMS Service Leaders



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Basic Facts and Comparisons Between Service Bridge, Field Bridge and Field Bridge Express Reference for EMS Service Leaders December 21, 2012 Field Bridge: The Bureau of EMS has obtained federal Grant funds to obtain a statewide Field Bridge License for all services to use at no cost for the software, similar the TEMSIS system. Services will be responsible for obtaining their own computers or mobile devices to use these programs, but will not have to bear the cost of purchasing a license for each device or the annual maintenance fees they must pay now. To take advantage of this program, services will need to submit an application to the Bureau so they can be issued a service key, required to be entered once program is loaded onto your computers. If a service currently has one or more computers with Field Bridge on it and wishes to add more computers, that service will also need to submit an application to be issued a service key for any additional computers. While no service will have to pay annual fees to ImageTrend for maintenance after this goes into effect, services will not be able to get a refund for any Field Bridge License they have previously purchased directly from ImageTrend, Inc. Field Bridge Express (FBX): In addition, the Bureau has obtained 35 site (service) licenses for the Field Bridge Express. This is the lite mobile tablet version of the software that can be used with ipad and Android tablet devices. A site license will be issued to a service and the service can use as many devices as they wish on the site license for that service. The Bureau will be issuing the Field Bridge Express site licenses on a first-come, first-served basis. Once we have issued all 35 licenses, services will either need to purchase a license from Image Trend directly and pay annual support fees, or submit an application and be placed on a waiting list in the event a site license is repossessed from another service for failure to meet agreement requirements or lack of use for 60 days. Availability Date: When will the Field Bridge and Field Bridge Express be available? All state required paperwork has been submitted to administrative services at this point and we are waiting to find out if the contract amendment will be accepted for the Governor and Council meeting scheduled for January 16 th. HOWEVER As this is the first meeting for the new Governor and Council, no one is sure what will be accepted onto the agenda at this point. Worst-case scenario, the contract will be bumped onto the February meeting agenda. The date for that meeting has not been posted yet, but the meetings generally fall on the first and/or third Wednesday of the month. Either way, the Field Bridges will not be finalized and active until they are approved by the Governor and Council, so we will all be waiting in anticipation.

Many services have already called us with questions and interest about the statewide Field Bridge, and particularly about the Field Bridge Express. To help answer service and provider questions, we have put together this basic comparison of features and description of some important functions to help service leaders better understand what their options will be in the near future. What s the difference between Service Bridge, Field Bridge, Field Bridge Express (FBX) and Rescue Bridge? See the attached comparison table to compare features on page 5. Service Bridge: This is the desktop version that everyone uses now. Accessed through the website and requires a constant internet connection to use. Field Bridge: This is the laptop version that most people know about. A program is installed on the laptop (or could be a desktop as well) and doesn t require an internet connection to create a run. Runs are then posted through the internet to the service s Service Bridge account in TEMSIS. Field Bridge Xpress (FBX): This is the ipad / Android tablet version and is essentially Field Bridge lite. It does not use an app loaded on the device, but must connect to the TEMSIS site before using the first time for each user. It can then create a run offline and post it to TEMSIS once there is an internet connection. Rescue Bridge: This is Image Trends combined NFIRS (fire) and EMS reporting program. It works like both Service Bridge and Field Bridge, allows for entry of both NFIRS reports and EMS reports, will populate all the similar fields in each report without having to enter it twice, and has many features that fire departments like, such as preplanning, inventory control, inspections, investigations etc. It is web based and can be used real-time in the field and can be integrated with a CAD system. Currently, the state does not provide this program (although we have done our best to interest the State Fire Marshall s Office in obtaining this program statewide for all Fire services, similar to the TEMSIS system). Services that are interested in the program can purchase it directly from Image Trend at this time. Additional Information About Field Bridges All TEMSIS users will still need to be affiliated with a unit and have a TEMSIS account for that unit to use any of the Field Bridge features. For any Services who currently have a Field Bridge License and have been paying annual maintenance fees: There have been many legitimate questions from these services about what happens to their fees when the statewide license kicks in. Image Trend has given us a ruling about this: 1) If your service has recently gotten an annual maintenance fee bill, DO NOT PAY IT AT THIS TIME. Image Trend will do one of two things once the statewide license kicks in: 1) bill your service for the time you owe, or 2) forget any recent outstanding bills since we are gong to a statewide license (probably the later, unless you owe in arrears). 2) If your service paid an annual fee in the recent past, you will need to contact Image Trend once the statewide license kicks in to get credited back the remaining amount of your fees for the year. YOUR SERVICE MUST DO THIS, Image Trend will not go looking for you to give money back! 2 of 6

Field Bridge Facts Field Bridge provides many power tools that allows for rapid data entry and supports electronic EKG and vitals integration with Physio-Control, Zoll and Phillips monitors. While Field Bridge is convenient and has some features not available in the Service Bridge-such as the EKG integration and Power Tools, it still lacks some administrative features that are present in the current Service Bridge such as updating run status, adding QA/QI Notes, and managing your service settings. Field Bridge Xpress Facts The Field Bridge Xpress was released for the first time as of August 2012. Being that this was Version 1, there are still many unknowns. There are also functionalities such as EKG Integration that are not, and may not ever be supported for various reasons. This is the first release for mobile devices and while ImageTrend has already made a number of upgrades to that first release and we are very excited about the potential for this program, keep in mind that this is a relatively new technology which provides a base to improve upon going forward into the future. This program is not the full TEMSIS for the ipad, but is a lite version of the program. Here are a couple of key factors that we know right now about FBX: Image Trend has recently added some administrative controls that will let the service determine when a run is deleted from a device. We expect that there will be room for improvement in the area of administrative controls over the next 6 months or so that may not be obvious in need until this starts to be used by multiple services. Image Trend is building this program to be hardware agnostic -meaning they are trying to make it so it will work on any type of device and not rely on just one particular operating system, program or piece of hardware. However, they can t account for some limitations built into some of the hardware (like early version of the Kindle), so the program may function with varying degrees of success depending upon the device you choose. Stay with primary market, mainstream, nondiscount quality devices and there should be no issues of functionality. Make sure your device fully supports HTML5. As each user signs in from a device, the server will issue them a unique encryption key that the system will then use to recognize them in the future and will encrypt any data on the device to that person. Each person that signs in from a device gets a unique encryption key. That means if you have ten users on a service device, all ten users essentially have a separate stovepipe account on that device. There is no app to use TEMSIS from a device. You simply access the TEMSIS website from the device, get your encryption key and then need to create a bookmark for the TEMSIS URL and your login so you can get back to your login page for that service on that device. Every user will need to set up a bookmark for themselves on a device. Likewise, if a user has multiple services they are entering runs for on a device, they will need to set up a separate bookmark to get them to the correct service to enter a run, rather than signing in first and choosing their service as they do now. In FBX, you sign into a specific service account, rather than signing into TEMSIS in general, and then choosing your service. Runs are stored securely in the device s cache memory. Image Trend initially estimated that each device might be able to store 50 or 100 runs at a time. Now they feel that devices may be able to store hundreds, if not thousands of EMS runs. Each provider who uses a device will essentially have their own little secure section of the cache memory keeping track of their runs. 3 of 6

Services will be responsible for managing what devices are being used to access TEMSIS for their service. Services will also be responsible for insuring they have a plan to delete any incident reports on a device on a day-to-day basis, if the device is lost, stolen or damaged, or if the service is allowing their providers to use personal devices. Field Bridge Xpress is an exciting new option to enter runs forms, but it is a more limited program than the current TEMSIS system or even the Field Bridge program and providers and services should not expect this program to do everything for them. It is designed to improve the ability to create most of a runform at the patient side and help speed up the run form entry process and accuracy, but is not, and cannot be the full solution to runform entry by itself because of limitations in the hardware and operating systems available. See following page for a table comparing TEMSIS Bridge features. NOTE: These functions are subject to change or be upgraded based on improvements in the software, changes to major software operating systems such as Microsoft Windows, changes to hardware specifications and functionality and limitations of outside equipment (such as ECG Monitors). This comparison is base upon the best information available to us at this point in time. 4 of 6

Comparison of TEMSIS Bridge Features Functionality, Features and Benefits Start, Enter, and Save Incidents Service Bridge Version 5.x EMS Field Bridge Version 5.x Field Bridge Xpress (FBX) Version 1.0 Online (Connected to the internet) No Start, Enter, and Save Incidents Offline (NOT Connected to the internet) Central/Single Login Page for all Providers No 1 Upload Runs to Field Bridge to continue working on them N/A N/A 2 Upload Runs to Service Bridge Requires Download and Installation of Program onto computer or device to use No No Can Store Multiple Runs in the Computer/Device Memory No Central Admin Controls for Deleting Runs Stored on No Device/Computer Capture Electronic Signatures Provider Actions (Power Tools) No for vitals procedures, meds, etc Customizable Display Fields for Power Tools 4 No No Works with CAD Integration 5 Run Validation applied to an incident when connected to the internet Run Validation applied to an incident in real-time while entering it No Runs on Windows XP No Runs on Windows 7 Runs on Windows 8 Runs on Windows 8 RT(Runtime) No No Runs on iphone No No 6 Runs on ipad 2 and Newer No No Runs on Android 4.0 and Newer No No Runs on Kindle Fire No No 7 5 of 6

Nexus 7 No No Customizable Login Page No No Available Critical Care Module 8 No Supports Printing / PDF Generation No Event Visibility (Dynamic Changes to the Runform) No Active Protocols No Add Attachments to epcr No Lookup for Repeat Patients 9 Track Consumables 10 No Configurable Default Values No EKG Integration with Monitors No No Service Defined Questions No 1. Service Bridge and Field Bridge have the same login page that all users use. With FBX, each user has to create a bookmark on the device with their login, that links them to their personal encryption code. For example, if you had 5 providers using a device, there would have to be 5 bookmarks, one for each provider to access the TEMSIS system from that device. 2. Requires integration through CAD integration to be able to upload directly from the FBX to the Field Bridge. Does not require that your service be set up for CAD integration, but more connectivity steps required to make this work. 3. Image Trend is working on a way for Service administrators to control when runs on a device get deleted using FBX. Currently, only the provider on the run can delete a run record on a device. This is not a batch function, but each record needs to be deleted individually. Image Trend is working on adding more functions in this area in the next version release. 4. This is the ability to shut off any elements that you don t want to collect in a power tool so it will not show on the run form. For example, NH does not collect IV Site Condition, but the power tool in regular Field Bridge displays this question. In FBX we will be able to turn this off so we don t have to see it. 5. The Service must be set up for CAD integration and an internet connection is required at some point while completing a runform to download and update the CAD information on the runform. 6. Will work on an iphone, but the small screen makes navigation very difficult and cumbersome so this isn t very practical to use. 7. Image Trend says: We have been having weird issues with the latest version of FBX running on the Kindle Fire, so do not recommend this hardware at this time It will be interesting to see how the new Kindle Fire 2 works. The Kindle has limited support for HTML5 in their current software and the FBX is written in HTML5. The programming will work on a Kindle, it just has various quirks due to the browser programming that Kindle has put on their device. 8. NHBEMS does not provide a Critical Care Module. Services interested in this will need to purchase this separately. 9. Only when connected to the Internet. 10. This is an extra feature that services must purchase separately from Image Trend. 6 of 6