Health Information Exchange
Connecting EMS to the broader health care system through health information exchange.
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The U.S. Department of Health and Human Services defines Health Information Exchange (HIE) as "electronic movement of health-related information among organizations according to nationally recognized standards." The goal of HIE programs is to facilitate secure access to clinical data to provide safe, efficient, effective, equitable, patient-centered care. Health information exchange relies on a bi-directional flow of data covering all aspects of the patient care continuum including dispatch, field care, transport, emergency department, hospital admission, hospital discharge, and practitioner care.
EMS is an integral part of the health care system - actions taken by EMS providers at the scene and enroute to the hospital affect outcomes, quality of care and patient satisfaction. HIE allows providers in the field to appropriately access and securely share a patient’s vital medical information electronically.
Currently, few EMS systems are connected to a health information exchange or other electronic health/medical records system. There are many challenges to sharing of EMS data, including funding, proprietary systems, and a lack of collaboration. EMSA is working to overcome those challenges and support providers, health information organizations, vendors, and local EMS agencies in creating the infrastructure necessary for secure two-way exchange between EMS and other health care providers, facilities and payers.
It’s our expectation that EMS will become a full participant in the electronic exchange of health information in the near term with the capability to:
- Search a patient's health record for problems, medications, allergies, and end of life decisions to enhance clinical decision making in the field
- Alert the receiving hospital about the patient's status directly onto a dashboard in the emergency department to provide decision support
- File the emergency medical services patient care report data directly into the patient's electronic health record for a better longitudinal patient record
- Reconcile the electronic health record information including diagnoses and disposition back into the EMS patient care report for use in improving the EMS system
When a disaster occurs, individuals may require medical attention from hospitals and other medical providers that do not have any previous history treating those patients. In addition to +EMS use cases, it is also our goal that EMS will become a full participant in the electronic exchange of health information in disaster use cases, using the PULSE system. Consequently, the patient’s health information, including medications, allergies, major illnesses, etc. is often unavailable to disaster volunteers, emergency responders, and emergency facilities caring for them during a disaster, leading to suboptimal care and potential patient safety issues. To support the exchange of individuals’ health information during a disaster, the Emergency Medical Services Authority (EMSA), the Office of the National Coordinator for Health Information Technology (ONC), and the Office of the Assistant Secretary for Preparedness and Response (ASPR), has partnered to develop and deploy a Patient Unified Lookup System for Emergencies (PULSE) in the State of California.
The PULSE web portal on the California Disaster Healthcare Volunteers (DHV) site will be activated by EMSA and the PULSE system will connect multiple local data sources (health information organizations and health systems) during a disaster. Once activated, disaster medical volunteers will be able to connect to the PULSE system in order to check patient records for allergies, problem lists, and medications in order to allow the health care providers in DHV to make better clinical decisions. PULSE will allow disaster medical volunteers registered and logged into California Disaster Healthcare Volunteers (DHV) application to access PULSE, once they have been assigned to a formally designated disaster, and are preparing to treat disaster patients. California’s DHV system routinely verifies credentials of registered medical volunteers to ensure that patients will receive care from adequately credentialed medical personnel. If you want to become a Disaster Health Care Volunteer and you are a Medical Doctor, Registered Nurse, Family Nurse Practitioner, Physician Assistant, Paramedic, or a Pharmacist, and would like to have access to the PULSE system during a designated disaster please, register at www.healthcarevolunteers.ca.gov.
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