the value of ems data in operations, biosurviellance and ...the value of ems data in operations,...
TRANSCRIPT
The Value of EMS Data in Operations, Biosurviellance and
Disaster Management
March 2, 2016 Alexander Garza MD, MPH – Saint Louis University
Todd Stout – FirstWatch Inc
Conflict of Interest Alexander Garza MD, MPH Is the medical director for FirstWatch Inc, a data analytic software company for Emergency Medical Services Todd Stout is the President and CEO of FirstWatch Inc
Agenda • What is Emergency Medical Services (EMS) and how does it work
• What data is generated by EMS providers
• What makes EMS data unique
• How to use EMS data to improve operations, surveillance and delivery of
care
Learning Objectives • Explain the different types of data that EMS collects for analysis
• Comprehend why EMS data is unique in healthcare because of its structure
• Define how data from EMS sources can be used in surveillance, QI and operations
http://www.himss.org/ValueSuite
STEPS • EMS Data improves disease pattern recognition in the community
• Using EMS data improves the delivery of care to patients
What are Emergency Medical Services (EMS)?
• Care delivered outside of the Hospital • Small percentage of healthcare market (1%) • $4B industry
What are Emergency Medical Services (EMS)?
• Multiple different types of agencies – Traditional – Fire Department Based – “Third Agency” – EMS separate from Fire Department – Private – for profit – Private – Not for profit
• Staffed by similarly trained and licensed personnel – Emergency Medical Dispatch (EMD) – Emergency Medical Technician (EMT) – Paramedic
What are Emergency Medical Services (EMS)?
• Originally mostly “emergency calls”
• High percentage of “non-emergency calls”
• Expanding mission now includes care outside of traditional EMS
– Community Paramedicine – Mobile Integrated Health Care (MIHC)
What makes EMS Unique?
What makes EMS Unique?
• Structure – Quasi-monopoly of the delivery of care delivered to
citizens outside of the hospital – Governed by geographical boundaries instead of payer
plan
• Healthcare Delivery – Consistency – All care is usually dictated by single protocols – All care is delivered by single level of provider
What makes EMS Unique?
• Economics – Local subsidy – Insurance, Medicare, Medicaid – Everyone is in their plan!
What makes EMS Unique?
• Challenges of EMS Model – Public Safety vs. Healthcare Provider – No market pressures – No ability for the patient to chose a provider – No agreed/established metrics to measure
performance – Payments for care are not tied to performance – Limited outcomes data
What makes EMS Unique?
• Benefits of EMS Model – Delivery of care is consistent (either good or
bad) – Service is uniform across populations
(geography) – Data is collected reasonably quickly (minutes) – Data collection is almost all electronic – Data is usually centralized
What Happens When You Call 911
• Primary Service Answering Point (PSAP) – Usually law enforcement – Data captured
• Phone number • Location (geocoded) • Near real time
What Happens When You Call 911
• Emergency Medical Dispatch – Consistent script of questions (usually) – Assignment of a code for patient condition
(consistent) – Response is dictated by answers to questions
• Level of response • Acuity • In some systems – no response
– Data capture in near real time
What Happens When You Call 911
What Happens When You Call 911
• Care Provider (EMT, Paramedic) – Sophisticated equipment – Electronic Patient Care Report (ePCR) – Data captured in near real time
What Happens When You Call 911
What Type of Data Does EMS Have?
• Dispatch – Phone number – Latitude and Longitude of caller – Type of complaint (car accident, heart attack,
etc) – Basic demographic information
• Age, sex, etc – All data is time stamped
What Type of Data Does EMS Have?
• Patient Care – Paramedic impression – Vital signs, trauma scores, etc – ECG, Glucose, Pulse Oximetry, – Medications, Allergies – Care delivered – All care usually time stamped
How Can We Use EMS Data to Improve Quality, Perform Surveillance and Improve Operations
Improve Quality of Care • Single repository for all care delivered outside of the hospital • Progressive EMS systems are establishing metrics • Measuring using near real time data • Initiative to develop standardized metrics – NHSTA COMPASS
Improve Quality of Care
Improve Quality of Care
Improve Quality of Care
Improve Quality of Care • Compare care delivered for the entire population of providers • Compare care delivered for the entire population of patients • Tie care delivered by EMS to hospital outcome
Improve Operations • Out of hospital care delivery is amazingly predictable including
– Volume of calls – Type of calls – Location of calls
• Progressive systems use demand data to build delivery models – Staffing need – Location of need
• Demand models are more flexible than static models • Provide more cost savings and efficiencies
Improve Operations
Improve Operations
Improve Disease Surveillance • Look at data across geography, not by institution • Types of calls are predictable • Able to “normalize” data
– Look for aberrancies • Special events
– Able to “fence” areas and screen calls • Any number of correlates
– Weather – Infectious disease – Drugs of abuse
Improve Disease Surveillance
Improve Disease Surveillance
Improve Disease Surveillance
Improve Disease Surveillance
Questions • EMS is a rich source of Data
• EMS provides “population” health
• EMS data is operational, clinical and public health oriented
• EMS data can be used to improve all of the above
Please use this blank slide if more space is required for charts, graphs, etc.
To remove background graphics,
right click on selected slide, choose “Format Background” and check
“Hide background graphics”.