Data Integration – Why EMS is a Great Partner for Hospitals
There are fewer faster or dramatic ways to change the relationship between EMS and hospitals than with the vendor-agnostic, bidirectional data exchange that comes with ESO Health Data Exchange (HDE). From the EMS side of the equation, the value is obvious – getting patient demographic information from the hospital can drastically improve EMS billing, and receiving patient outcome data from the hospital has unprecedented advantages for EMS learning and quality improvement.
Still, EMS/hospital data sharing isn’t a one-sided equation. Indeed, some of the biggest benefits accrue to the hospital, according to Wave 2018 speaker Karrie Austin, RN, Trauma Program Manager and EMS Coordinator at Good Samaritan Hospital/Multicare Health System, in Puyallup, WA.
When Good Samaritan was considering HDE, Austin discovered that the hospital leadership simply hadn’t considered the monetary value to the hospital. Take referrals, for example. “In my county, EMS is the number-one referral source — they bring us over 45,000 ambulance transports a year, 49% of which are admitted, paying customers that are admits,” she said. “The hospital never considered that or saw that as an added value to them.” Understanding that patient referral source and being aware of trends would be enormously valuable, but it simply hadn’t occurred to the hospital executives that it would be smart to have access to the data to do so.
Another highly valuable benefit to hospitals – not just in improved patient care, but in dollars – is access to information needed for registries. Hospitals must meet core measures in areas such as trauma, STEMI, stroke and sepsis. And when EMS reports don’t make it into the hospital record, the hospital has to try to track down prehospital data manually to meet their mandates. “We weren’t very successful at that – we maybe got 50 percent of the information,” said Austin. “That [made it difficult for] the hospital to meet their core measures.” Data exchange through HDE was a faster, better and more complete way for the hospital to get the information for registries.
What makes EMS such a great partner is not just its interest in improving patient care, but also the general EMS culture of building bridges with outside agencies, be they other first responders, community programs, or healthcare providers. “Just collaborating has value,” Austin said.
Now that Good Samaritan/Multicare has the data, what are they doing with it?
Return on Investment
“Executive leadership in the hospital [always] wants to see ROI,” Austin said. Good Samaritan found return in areas such as decreased HIPAA security risk (no printed EMS records lying around); less labor doing data entry for registries; and the positive impact on reimbursement for meeting core measures in the hospital.
“One of the nice things we’re using through Analytics is identifying high-utilization areas for 911, and [we can] put more resources, more education, or another ambulance in those areas,” Austin said. “We can also compare prehospital diagnoses with the end diagnosis [to drive] QI programs, and benchmark against not only other hospitals in our region but nationally.”
Improving Patient Care
“The standard for STEMI from EMS on-scene to balloon time is 90 minutes,” Austin said. “We’re now trying to shoot for 60.” That means making protocol changes such as doing the EKG en route to save time. For sepsis, with a goal to initiate IV fluids and antibiotics within 10 minutes of a positive sepsis score, Austin’s team worked with EMS to come up with an EMS sepsis scorecard. (An added benefit: “Now we’re able to meet our core measures in the hospital by getting those 1 to 2 liters and antibiotics on board in the first hour,” she said.)
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