Transcript What’s the Rush?

Emergency Medical Services Data
Jay Bradshaw, Director
Maine Emergency Medical Services
Department of Public Safety
Maine EMS
EMS patient/run report data system since
1979; standardized and mandatory since
1982
 Largest state EMS data repository in US:
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> 3.7 million records since 1980
~ 250,000 calls in 2006
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Standardized data dictionary
– NHTSA essential data elements
– NEMSIS
Maine EMS Run Reports 1980 - 2005
250,000
200,000
150,000
100,000
50,000
0
1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
How are MEMS data used?
System evaluation
 Quality Improvement
 Protocol changes (Tx & Rx)
 Public information & education
 Legislative information
 Research
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Maine EMS
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Marcolini EG, Burton JH, Baumann MR, Bradshaw JR: A StandingOrder Protocol for Cricothyrotomy in Prehospital Emergency Patients.
Prehospital Emergency Care, 2004; 8: 23-28.
Burton JH, Baumann MR, Maoz T, Bradshaw JR, Lebrun JE.
Endotracheal Intubation in a Rural EMS State: Utilization and Impact of
Skills Maintenance Guidelines. Prehospital Emergency Care, 2003;
7:352-356.
Pazdral TE, Burton JH, Bradshaw JR. Amiodarone and rural EMS
cardiac arrest patients: A cost analysis. Prehospital Emergency Care,
2002; 6:291-295.
Burton JH, Dunn MG, Harmon NR, Bradshaw JR. EMS Provider Findings
and Interventions with a Statewide EMS Spine Assessment Protocol.
Prehospital Emergency Care, 2005.
Maine EMS
Abstracts:
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Marcolini EG, Burton JH, Baumann MR, Bradshaw JR: A
Standing-Order Protocol for Cricothyrotomy in Prehospital
Emergency Patients: Utilization, Indications and Outcomes.
2002 SAEM Assembly
Pazdral TE, Burton JH, Bradshaw JR. Amiodarone and Rural
EMS Cardiac Arrest Patients. 2001 SAEM Assembly.
Paper, Bits, and Bytes
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Paper, and lots of it
– Expensive
– Entry “issues”
– Timeliness, or not
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First attempt
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RFP
Contract awarded to small company
Lots of interest, but
Lousy technical support
Second attempt
Plan of Action
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Survey to all EMS services
– 65% responded (185/285)
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Interviews with
– Services (5)
– Maine Medical Center (ED, trauma, & research)
– Bureau of Health
– Fire Marshal
– Maine Health Information Center
Survey Results
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The haves (162)
– OS primarily Windows
– Majority have Internet access
– Computer support
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The have nots (23)
– Budget
– Size of agency
Survey Results
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Willing to use web-based application?
– Yes (77%)
– No (23%)
 Budget / size of agency / Internet access
 However – they would use one if required to do
Plan of Action
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Educate EMS providers
 3 phase plan
– Web based application
– Client software
– Reporting tool w/ data mining
Essential to Providers
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HIPAA
 Export to billing
 Import from other programs
– Billing & CAD
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Not require broadband Internet
 Standard and ad hoc report generating
Important to MEMS
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NEMSIS
 Include all EMS runs, from all services
 User friendly
 Import from other formats
 Experience with NEMSIS, HIPPA, and
EMS systems.
 EMSSTAR Recommendation
MEMSRR
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RFP
 ImageTrend
 Training, training, and more training
 Partnership with Maine CDC (Bureau of
Health)
 Grants
Lessons Learned
People who said ‘yes’ at one time do not
give up their right to change their mind.
 Computer proficiency is much less than
anticipated
 Change is bad
 Change from paper is very bad
 Staying the course helps more than a fancy
brochure
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Be honest about the learning curve
Hospitals in the midst of converting to electronic
records may be less-than-enthusiastic about
another such change, but with time and attention
will become invaluable allies.
Neighboring states can help, sometimes
Web hosting is a bigger deal than anticipated
PDAs are great for grocery lists, but not as great
for PCR
NEMSIS is only a starting point
NICE (National State Enhancement) Codes
– PIFT/ATV/Skiing/Moose & Squirrel
State of the State
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33 services
 25,000 records