MDNews - Mid Hudson

FEATURE Emergency Medical Services ENGAGE ELECTRONICALLY EMERGENCY MEDICAL SERVICES (EMS) MAY BE THE FIRST CONTACT MANY PATIENTS EXPERIENCE DURING AN EPISODE OF CARE. BUT IN TERMS OF ELECTRONIC CONNECTIVITY, MANY EMS PROVIDERS ARE STILL IN THE WORLD OF PENCILS AND CARBON PAPER. IN SOME HEALTH CARE SYSTEMS, THOUGH, EMS IS ACHIEVING INTEROPERABILITY IN EXCITING WAYS. record (EMR) access outward for use by emergency medical technicians (EMTs). Serving 133 hospitals and almost 7 IN million people in a 20-county area, Healthconnect is a health information exchange organization spanning an area and population as big as some U.S. states. "One of the fi rst pilots of the exchange in the greater Houston area is hopefully going to connect emergency medical services with hospital emergency departments [EDs]," says Jim Langabeer, Ph.D., EMT, President and CEO of Greater Houston Healthconnect. Langabeer continues, "We'd like to see the ability [for] the ambulance medics and EMTs to access the same information [about] a patient as they present." That's a diffi cult task, but the need is great, too. "Although we have EMS — and there are probably 40 or 50 different agencies in this area that ultimately might want to be part of our organization — they all come at different levels of technological development," Langabeer says. "Some are more advanced; some are still on paper; and some don't allow remote access from the field on tablets, which is the most common way of entering information from ambulances. "One challenge will be getting people to the level at which they really can interact and have interoperability between their systems and a hospital system." TEXAS, GREATER HOUSTON Healthconnect is on its way to doing just that — pushing electronic medical Security barriers also hold back out- bound EMR data to ambulance teams. "There are fi rewalls between EMS and hospitals for good reasons," Langabeer says. "A lot of times, you don't want to share confi dential information, and it has to be about the right patient." Costs also militate against extending EMS interoperability. As Langabeer explains, volunteers comprise a large portion of EMS staff across the country, and limited funding can be challenging. In addition, there's just not much time for EMTs to fi gure out patient-unique identi- fiers and rummage through electronic records in emergency situations. Despite these challenges, Langabeer is determined to see Healthconnect's project succeed. "Fifty to 60% of people who get admit- ted into a hospital come through the emergency department," he says, "and in Houston, the biggest challenges, in terms of wait time, are also in the ED. That's where indigent and homeless, underserved, and uninsured folks tend to present the most. "So, giving the ED access to what happened prehospital, in terms of the ambulance, and then giving the ambu- lance access to what happened previously in the ED — we think it's going to be of tremendous value." Healthconnect hopes to achieve EMS-EMR access throughout a territory reaching from Houston to Galveston and into Louisiana. Much paperwork will be required before participation is confi rmed, but it appears the wait will be worth it. In Pennsylvania, Practice Laps Make Perfect Not all communities can afford large- scale disaster management training, but Lehigh Valley Health Network (LVHN), in partnership with Pocono Raceway, does just that. And interoperability is a key factor. "Pocono Raceway is a unique medi- cal environment," says Mike Wargo, R.N., administrator of emergency opera- tions and public safety for LVHN and Executive Director of Medical Operations at Pocono Raceway. During race week, Pocono Raceway may see 300,000 guests, including spectators, staff, crew and drivers. "The racing event is about a six-day period for us," says Wargo. "It usually starts on Tuesday and continues through teardown on a Monday. In that six-day period, we've had upward of 350 patients, primarily 200- plus on race day itself, and we've had as few as 50 patients over the course of six days." To this busy, if structured, chaos, LVHN Office of Emergency Management and Emergency Preparedness brings a mobile fi eld hospital that is typically on standby for disaster response. Interoperability based on strong partnerships and sturdy technology makes it all work. Providers transmit fi eld notes to EDs via remote access, using e-mailed text or PDFs. "We aren't able to bring a whole infra- structure, computers and networks to this mobile setting," Wargo explains, "so we [went] old school." Using a digital pen system, they achieve what Wargo calls "a rapidly deployable electronic medical record that does not

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