To promote effective use of HIE among California’s emergency medical services agencies, the California Health and Human Services (CHHS) Agency awarded a grant to the state Emergency Medical Services Authority (EMSA). Several stakeholders in the state shared some of the lessons learned at the EMSA Summit held in late 2013 on how to effectively use health technology.
In 2011, the Los Angeles Fire Department (LAFD) transporting 600 patients each day rolled out their electronic Patient Care Record (ePCR) program and distributed portable electronic devices to all field personnel.
The system has a cloud-based database for easier access to standardized data fields in their ePCR. The original equipment is being upgraded this year to a tablet style device that uses Window 8 and capable of 4G cellular access.
The Orange County EMS has created a web-based hub known as the OC-MEDS that functions as either a central database or EMR. “In many ways it functions like an HIE, but not to the true extent of an HIE,” reports Laurent Repass, a paramedic and EMS coordinator. The system went live towards the end of 2013.
Hall Ambulance, a dominant emergency provider has been using electronic patient care recordkeeping for 15 years. While the system allows Hall Ambulance to track its own work internally, improvements are needed to enable responders to look up information on the patient’s previous care. They would like to see their own care notes transmitted into a community or hospital record system.
OC-MEDS is able to send patient information into a county emergency agency database once every four hours. As the hospital patient information is printed and left at the emergency department, another copy is faxed to the medical records department. Soon the information will be sent directly into the hospital’s information system.
The Contra Costa County’s EMS, is examining workflows, determining how to connect the pre-hospital system with the Epic EHR system in hospitals, and piloting a dashboard for the hospitals capable of providing color-coded real-time information on patients to be placed in a location that will enable EMS personnel to view the data at all times.
The Monterey County EMS agency hired a database developer to carry out mapping between the ambulance provider AMR to link to the ePCR system and hospital records so that the data from one record would end up in the correct data fields of the other. The emergency agency learned that it really needed to have a health IT expert on its staff to accomplish some of the technical goals.
According to Ron Holk, RN, EMS Nurse specialist for the Inland Counties Emergency Medical Agency (ICEMA), missing from their quality-improvement efforts was not knowing what was happening to patients after they arrived at the hospital.
Specifically, the agency wanted to provide the base hospital that advises the paramedic to be able to expand on standing orders so that that information would remain in the patient’s record rather than being strictly verbal.
In addition, ICEMA is working to expand access to its ePCR system to four other EMS agencies and also working on integrating their database with the Inland Empire Health Information Exchange.
Go to www.ohii.ca.gov/calohi/Portals/0/Documents/eHealth/News/EMSAGrantStories.pdf for the “Connecting California: California HIE Stakeholder Summit Report.”