Funding to emergency medical services to develop an HIE and interoperability is now available via Medi-Cal (Medicaid) through a process established by the California Department of Health Care Services (DHCS).
The State of California Emergency Medical Services Authority (EMSA) www.emsa.ca.gov has submitted a proposal to implement HIE for two critical components of the healthcare system to include both Emergency Medical Services (EMS) and to help with disaster response.
Currently few EMS systems are connected to a HIE or other electronic health/medical record systems. There are many challenges to sharing EMS data such as funding issues and a lack of collaboration.
Funding would be used to complete HIE on-boarding and to design and implement HIE architecture. This program is estimated to cost up to $40 million ($10 million per year) and would last through September 30, 2021. Matching funds estimated to be over $4 million would be obtained from county fund sources and the California HealthCare Foundation www.chcf.org.
It is estimated that up to 33 contracts at an average of $1 million each would allow EMS providers to onboard to hospitals, HIEs, long term care facilities, plus behavioral health and social services providers.
EMS is expected to become a full participant in the electronic exchange of health information with the capacity to:
- Search a patient’s health record for problems, medications, allergies, and end of life decision to improve decision-making in the field
- Alert the receiving hospital on the patient’s status directly onto a dashboard in the ED
- File the EMS patient care report data directly into the patient’s EHR
- Reconcile the EHR including diagnoses back into the EMS patient care report
It is also the goal in California, for EMS to fully participate in exchanging health information in times of disaster using the “Patient Unified Lookup System for Emergencies” (PULSE) System. So far, the EMSA, ONC www.healthit.gov, and the Office of the Assistant Secretary for Preparedness and Response (ASPR) www.phe.gov within HHS have partnered to develop and deploy PULSE within the state.
Integrating disaster operations would require creating interoperability which will include using PULSE to onboard to HIEs, provide for HIE to HIE interoperability, patient tracking, and patient matching.
PULSE web portal will be activated by EMSA and the PULSE system will connect multiple local data sources during a disaster. Once activated, disaster medical volunteers will be able to connect the PULSE systems to check patient records.