INTEGRATING EMS DATA COLLECTION & TRAUMA REGISTRY Joe Moreland Kansas Board of EMS April 21, 2015 1
PROJECT OBJECTIVES Improve data accuracy Reduce data entry time for hospitals Provide EMS data in a more timely manner Utilize web services vs. batch file upload for near real time accessibility Solve the missing EMS run form problem Return hospital information to EMS Foundation for data linkage to trauma, stemi, stroke and other databases (FARS), cancer 2
KBEMS ASSISTED WITH DESIGNING AND PURCHASING THE HOSPITAL BRIDGE 2010 Adobe Max Award Finalist. FedEx & Toyota Data are pushed Allows receiving hospitals to view, download or print the PDF of the EPCR Has many search capabilities Solved many issues Hospitals cannot find EPCR Cannot read the writing The second generation photocopy of the third carbonless sheet is illegible Fax Varied results 3
SELLING THE CONCEPT TO HOSPITALS No cost $$$$$ Only need a computer with a web browser No software installed locally Secure connection Easy to learn Hospitals can add and inactivate their own staff Populates 30 NTDB core data fields of EMS data including the narrative 4
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TRAUMA REGISTRY - COLLECTOR 100 hospitals used web based version 25 hospitals use client version Mandatory that all hospitals participate Digital Innovation (DI) does hosting and runs reports Core (web based) 80 elements Optional (client) 300 elements 8
TRAUMA REGISTRY STATISTICS 2011 Trauma Registry Data 11,500 patients 6,000 transported by EMS (2% of EMS transports) 9
COLLECTOR UPLOADS Hospitals upload monthly or quarterly Upload to KDHE 45 elements Patient identifiers stripped Hospitals upload to the NTDB Data do not go from hospitals to KDHE to NTDB DI has a live server for 100 web based hospitals 10
KEMSIS PARTICIPATION 85 of 172 services participating Current effort is to import data from 20-30 services using NEMSIS software other than ImageTrend (6 vendors) 60% of state call volume Largest obstacle are the codes for health care facilities KDHE uses CMS number KBEMS uses the state license number Kansas City & Wichita made up their own numbers 11
PATIENT IDENTIFICATION/MATCHING KDHE & KBEMS do not have the staff or $$$ for probabilistic linkage 12
EXPECTATIONS Inexpensive Easy for EMS attendants & hospital staff Accurate Secure Work Missing patients Missing data elements Data elements out of range Client & web based trauma registry software 13
OPTIONS Six months of research & brainstorming What other states do? Successful Unsuccessful Consistency Missing patients Trauma band & tag Logistics Cost 14
SOLUTION ImageTrend and DI DI Continuum of Care Server (CCS) CCS Software hosted at DI Patient matching & data exchange will be done at the hospital Hospital has relevant identifiers for patient match CCS checks to see if the EPCR is seeking is available CCS will use DI live server 15
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SOLUTION Trauma registrar logs into CCS and enters date patient arrived at hospital CCS sends web service call to ImageTrend and checks for all patients arriving the receiving hospitals 72 hours prior to and after the date entered Trauma registrar is presented a list of patients and selects the desired patient. 30 data elements are copied from KEMSIS and imported into trauma registry including the EMS narrative 2 Hospital elements returned to EMS ED disposition, E22_01 Hospital disposition, E22_02 $10,000 to ImageTrend plus the $30,000 for the hospital bridge $44,000 to Digital Innovations 23
FARS Fatal Analysis Reporting System NHTSA requirement for all states to submit data for traffic crashes that have fatalities FYI, the FARS manual for 2010 is 706 pages in length Too many fields for me to count. They do not use continuous numbering and I could not find it in a spreadsheet.
EMS ELEMENTS C28 Time EMS notified C29 Time EMS arrived at scene C30 Time EMS arrived at hospital
HELP!!! Michael Havenstein called and asked if he could have access to the KEMSIS database so he could locate EMS dates & times of fata crashes HIPAA Considered several options Answer the question Gave him the ability to run a report on KEMSIS
SOLUTION Added law enforcement permission group I wrote a report based that included the three fields that he needed and added eight additional fields to assist in identifying the correct patient KDOT already has the patients names NO $$$ except for 12 hours of my time and 2 of Michael s
QUESTIONS? 32
Joe Moreland, Paramedic, RN, BSN, MPA 900 SW Jackson, Room 1031 (785) 296-7412 joe.moreland@ems.ks.gov 33