CHAPTER 8
DATA & TELECOMMUNICATION
HISTORY AND CURRENT PROGRESS The benefits of harnessing EMS data and telecommunications are well known and long-sought. As early as 1966, the National Academy of Sciences’ Accidental Death and Disability: The Neglected Disease of Modern Society 110 identified a lack of [EMS] data as a core deficiency. The 1996 EMS Agenda for the Future listed Information Systems and Communications as core attributes of the EMS system, 111 and electronic patient care reports (ePCR) systems have been becoming more commonplace in EMS over the past 10-15 years. In 2001 the federal government provided funding to the National Association of State EMS Officials (NASEMSO) to develop a National EMS Information System (NEMSIS). Since 2005, the National Highway Traffic Safety Administration (NHTSA), the Health Resources and Services Administration (HRSA), and the Centers for Disease Control (CDC) have funded a NEMSIS Technical Assistance Center (TAC) at the University of Utah to support the 50 states and 6 territories. It is hoped that NEMSIS will one day provide a sophisticated, data-driven platform that improves patient care, workforce safety, training, and fully integrates EMS into emerging health care systems. In 2009, the Indiana Network for Patient Care was the first Health Information Exchange (HIE) to provide preexisting patient data to an EMS agency (Indianapolis EMS). This early experience demonstrated the importance and challenges of accurate patient matching. 112 It also indicated the need for longitudinal patient-oriented record-keeping instead of limiting data collection in EMS to incident-based collection and reporting. Since then a number of other states and localities have made progress on information exchange, but it remains exceedingly rare.
CHALLENGES TO INNOVATION INADEQUATE DATA COLLECTION Despite the creation of NEMSIS and the proliferation of ePCR vendors cited above, there are still too many EMS agencies that have not yet made the transition from paper to electronic records. In
addition, information that is currently collected is somehow simultaneously too burdensome on the frontline EMS providers and frustratingly limited to potential users of that data. EMS agencies are often required to submit significant amounts of data to multiple different local and state authorities, and possibly national-level data collection efforts on specific conditions, yet rarely receive any reports
110 “Accidental Death and Disability: The Neglected Disease of Modern Society.” Division of Medical Sciences, National Academy of Sciences, and National Research Council . Last modified December 1997. http://www.ems.gov/pdf/1997-Reproduction-AccidentalDeathDissability.pdf 111 Ibid 2. 112 Park, Seong C., and John T. Finnell. “Indianapolis emergency medical service and the Indiana Network for Patient Care: evaluating the patient match algorithm.” In AMIA Annual Symposium Proceedings , vol. 2012, p. 1221. American Medical Informatics Association, 2012.
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MOUNT SINAI HEALTH SYSTEM | UNIVERSITY OF CALIFORNIA, SAN DIEGO
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