A New Survey May Help Us to Know in More Ways than One.

Change.  It’s often a rather painful thing that we all tend to want to avoid.  And of course some change comes whether we want it to or not.

It would seem that as an industry, the EMS world is closing in on the eve of the universal electronic record era – and that does mean change is coming.  It is feasible, however, that this change will be both good in the long run and one we can be prepared for.

Electronic Data Benefits:

Consider the numerous benefits to this transition before we consider the uphill climb it may entail.

Time Critical Diagnosis is arguably the best progressive change we have embarked on as an industry in the state of Missouri in a number of years.  The end to which the lengthy TCD preparation is aimed is a statewide system that will coordinate the saving of lives to an extent that will surely justify the critical path we are all on now to make it a reality.  To maximize TCD and stroke/STEMI, electronic data will and must play an invaluable role.  

Forgive my “over fifty” descriptors, but how else will we beam critical patient information from the street  to the doctor who may be in the Emergency Department, at a seminar in Cleveland or dare I say, on the golf course?  And at the moment, when the 12-Lead data collection reveals STEMI is the diagnosis, how does the doctor beam that critical information to the waiting cardiac team which is now ten minutes away from receiving the patient?

Now of course, not every ambulance service has a money tree out back to cover the expense of the new hardware and software needed to do all of this beaming.  But let me continue with the benefits before I offer a potential solution to that concern.

As we approach electronic patient billing with Medicare and Medicaid the issue will be maximizing your billing results.  Electronic data.

As we work toward the Patient Safety Organization initiative which will undoubtedly allow us to make comparative analysis of pre-hospital diagnosis and treatment and hospital outcomes, we’ll have to use the one medium to make it a reality – electronic data.  Then we’ll know why, for instance, twenty percent of all patient cases, where the provider perception was pneumonia, are revealing a hospital outcome of asthma.  Such a potential disconnect in how we treat patients in the pre-hospital setting would be easily detectable and correctable provided the variances can be detected – and that can’t happen on paper which today is problematic and expensive.  Electronic data.

Now for some realities:

The integration of emergency medical health records into the growing electronic medical records system at the hospital level is on the move.  Currently the state is working with image trends and under regulation ambulance services are supposed to be sending in reports on critical patients.  Soon the state will move toward having all patient care reports submitted electronically.  Will it become a mandate?

Sherry Gastler recently conveyed to me that “homeland Security and the Obama administration are pushing the CDC to have every state in the union reporting electronically. The heat is on.”

Also, Health Level Seven (HL7) is the future of health records and reporting, I’m told.  Take a few moments to review the work NEMSIS is doing directly with Homeland Security, and the Patriot Act.  Simply google HL7.

Founded in 1987, Health Level Seven (HL7) is a not-for-profit, ANSI-accredited standards developing organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services. HL7's 2,300+ members include approximately 500 corporate members who represent more than 90% of the information systems vendors serving healthcare.

Currently, many ambulance services in Missouri do not collect patient reports electronically.  No surprise and for obvious reasons.

But the world is moving in this direction inevitably and when the day comes that we are all on the same electronic page we will want patient records to be relevant and portable so they can be integrated into the databases that are evolving nationally and within the health care system.  

We must move the EMS industry into the electronic patient record era sooner rather than later.

The issues of concern are clear – expense, difficulty and the unexpected.

Solution-oriented ideas:

To get this ball on a slow roll, the Missouri Ambulance Association is considering creative ways to assist the many services that may not have the resources to purchase the tablets and necessary software their crews will need to collect patient data, move that data around and submit it.  In the end, no matter the size of the ambulance service, we will all be a component of the broader picture.

One of the creative solutions involves preliminary research on whether a grant may be obtained to provide needed funding.  The interest is to see how MAA can help to enable the electronic data transition to avoid the potential advance of regulatory powers that will otherwise mandate it.  Making the transition for the right reasons will allay frustrations that might occur as a result of such a mandate or future dreaded deadline.

A new survey is on its way to Missouri ambulance services to determine basic information such as interest level, potential concerns and resource needs.

Certainly, there is a lot of work to be done with the electronic data transition.  No one proposes an overnight solution.  But as big as the issue is – and as distasteful as it may seem – we must keep our eye on this ball.

The participation in returning the MAA Electronic Data Survey is greatly appreciated.