spoke-and-hub distance training model with on- sight local medical supervision. Recent experience with community paramedicine has also shown that added training in longitudinal care is important for providers previously accustomed to incident-based medicine. IMPROVING CLINICAL FEEDBACK The role of EMS as a HIPAA-covered entity has been clarified (see NHTSA’s Information Sheet in Appendix) but local EMS champions need to make a concerted effort to educate hospital and health information exchange leadership and compliance officers about this issue. As the goal of bi-directional EMS-hospital information exchange gets closer, EMS agencies need to take
advantage of the data they already have access to and find ways to systematically provide clinical feedback to their providers for the sake of both EMS education and patient care. Reconciliation of EMS records to hospital records may be tedious, but it becomes slightly less so each year. Paramedics should no longer be left to wonder whether their assessment was consistent with that of the ED physician or whether their patient actually had a pulmonary embolus as the cause of their syncope. This dramatic health information technology (HIT) advance will allow EMS to consolidate its understanding of disease and injury and fix a critical defect in the current process of continuing education.
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MOUNT SINAI HEALTH SYSTEM | UNIVERSITY OF CALIFORNIA, SAN DIEGO
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