Oregon EMS Information System (OREMSIS), Secure and Protected Health Information Exchange/Reporting to Improve Care and Outcomes; Were not talking Star Trek Presenter: Dagan Wright, PhD, M.S.P.H. (Trauma, EMS and Injury Public Health/OHA) Thanks to all the EMS/Fire community, OTR registry and clinicians, OHA, ODOT teams & TRCC Contact information: dagan.a.wright@state.or.us or 971-673-1055
OREMSIS and NEMSIS? Close to real time patient record within minutes of the event or agency entering info. An EMS uniform national patient care information system with flexibility to meet local needs Uses common data definitions, structure and values nationwide open standards system ICD-10, SNOWMED, RXNORM, HL7, XML/XSD Open data system allowing supporting software vendor compliance (http://nemsis.org/v3/compliantsoftware.html) National EMS Information System (NEMSIS) www.nemsis.org NHTSA (National Highway Traffic Safety Administration) is the federal agency for NEMSIS A national surveillance system with over 50 million records since early 2000 s 49 states regularly submit data 131 National PCR Elements 207 Oregon PCR Elements Local PCR Elements 423 Total PCR Elements
Why s and uses of OREMSIS and OTR Data? The Oregon EMS Information System and the upcoming OTR update are to provide data and tools for: Evidence based information for (see EMS Compass and TQIP-ACS): Performance improvement, procedures, prevention activities Healthcare worker safety and health Public health investigation and crises Disaster preparedness and mass casualty planning and management Epidemiology, evaluation and research Securely push/pull information with other health information systems Data is close to real time and pushes up to the national system (NEMSIS) within a few minutes from OREMSIS and the OTR receives health care records within 60 days of discharge
Oregon EMS Information System Stats Currently there are 1.6 million Oregon EMS records, with over 270,000 EMS transport events annually added to the system Oregon is a VOLUNTARY reporting system, EMS transport agencies are NOT required to report until 2019 with implementation of SB 52 (for transport providers) Both Licensed Transport and non-transport responders can report For agencies using NEMSIS 3 patient care record data is available close to real time Oregon is moving towards only supporting NEMSIS 3 data standards
Crash Working on Future Oregon Linkage & Information Exchange EMS ED Information Linkage and potential for exchange Hospital Hub: currently working Push/Pull EMS and Trauma information to/from both systems Sept. 2017 ED/Essence Vital Records/FARS Reporting Inpatient/Trauma Registry
EMS, Trauma, Linkage and Information Exchange for 2017 foundation for future linkage and information exchange Why Decrease time and barriers to enter EMS information and use EMS information for What quality of care or the continuum of care Increase data completeness, quality, timeliness and use of the data Continual support for national standards Support secure, uniform, accurate and timely information exchange between EMS and Trauma Emphasize secure and privacy for information exchange and sharing of information within proper HIPAA and Oregon specific law SB 52 for EMS reporting and Hospital Trauma EMS information exchange Linkage feasibility methods and results for ODOT crash, EMS, Trauma, Hospital and vital records, and other systems September 2017 - Provide data exchange (using HL7, SNOWMED, RXNORM, XSD/XML ) pushing EMS information into the trauma registry once matched & push specified hospital outcome information back to the EMS provider demonstration project
Example of Data Quality Check Entering Data PUBLIC HEALTH DIVISION EMS and Trauma Systems 7
Example of an epcr in a PDF, Using Hospital Hub PUBLIC HEALTH DIVISION EMS and Trauma Systems 8
Beta Testing Direct Linkage for Trauma and EMS PUBLIC HEALTH DIVISION EMS and Trauma Systems 9
Using LinkSolv to link events/people in different information systems or databases PUBLIC HEALTH DIVISION EMS and Trauma Systems 10
Using RecordLink in R for ODOT Crash and EMS events Data: 2013 & 2014 ODOT and NEMSIS data including Year, Month, Day, Sex, County and City Blocking variables: Month, Day, Sex, County Excluded: City excluded from analysis due to causing lowered linkage probability PUBLIC HEALTH DIVISION EMS and Trauma Systems 11
Resources and Information NEMSIS site (www.nemsis.org) The latest guidelines for reporting and data quality guidelines at: http://www.nemsis.org/supportv3/stateprogressreports/oregon.html EMS Compass National ongoing performance standards at: http://www.emscompass.org/ NTSHA Initiatives including NEMSIS/EMS http://www.ems.gov/initatives.htm Data Linkage information http://www.oregonpublichealth.org/assets/epibio_section/cook%20epi%20forum%20linkage%202015%202.pdf ImageTrend for state hosted vendor http://www.imagetrend.com/ Oregon Trauma Registry https://public.health.oregon.gov/providerpartnerresources/emstraumasystems/traumasystems/pages/registry.aspx ATS and ACS http://www.amtrauma.org/ https://www.facs.org/quality-programs/trauma/ntdb
Thank you for your time and feedback Questions?