EMS
Data Collection
Prehospital
EMS Data Collection in Alaska:
A
Plan for Improvement
The Need for Statewide Data
Collection
The reasons for statewide
data collection are many and compelling. It will give us an opportunity
to
- advocate more
effectively for funding;
- modify training
programs to meet the needs of the EMS system;
- identify and anticipate
trends in patient care so the emergency medical services system
can grow in a resource efficient manner;
- allow research
and introspection that will improve emergency patient care and
focus injury prevention activities;
- facilitate comparison
of data with other systems.
All of these benefits
exist at the local, regional and state levels. In addition, most
of the newer software has very well developed billing capabilities
which can significantly enhance the revenue collection necessary
to sustain many services.
So, how do we move
forward towards a statewide system of electronic EMS data collection?
First, we accept that EMS agencies throughout Alaska have different
needs, resources and sophistication related to record keeping and
computerization. We need to find ways that we can collect data in
a minimally intrusive manner while providing reports which make
services want to participate in the program.
Activities which
will be undertaken by the Section of Emergency Programs include:
- Enhancing the
model State EMS Prehospital Run Report Form
- Developing and/or
adopting a standardized record format for accepting electronic
data (based
on the NHTSA Data Set);
- Making the input
data format available to EMS agencies and software
vendors;
- Developing computer
database capabilities to accept electronic data from patient care
reports sent by participating services via modem (dialup and internet);
- Finding ways to
help fund some start up costs for electronic record keeping.
- Develop the capability
to provide services involved in the statewide data collection
program with timely and meaningful reports.
One
limitation of this proposed system for collecting electronic
data (and there are probably others) is that it does not allow
emergency medical services with paper based computer records
to contribute patient care data on each run. We will still
send these services the EMS ambulance service survey. However,
it is unlikely that we will ever have the staff necessary
to manually enter these records directly.
There are several
models of data collection which can meet local, regional and
state needs for data. They include:
- Data entry
over the internet to a central server for low volume services;
- Entry of
paper based information into a computer for uploading to
the State EMS System Database; and
- Entry of
data into a pen based system for direct uploading to the
State EMS System Database.
Each method of data
entry needs to be accommodated in a statewide system and must be
able to track a patient through multiple transporting agencies and,
perhaps, across regional and state boundaries. The plan for
developing the system is outlined below.
The Partners:
We hope to benefit
from the active participation of many agencies an individuals in
the development and implementation of this project, including:
- Local EMS agencies
- Regional EMS Offices
- Alaska Fire Service
Training
- EMS Medical Directors
- Alaska Fire Chief's
Association
Funding:
The State EMS Program's
budget is insufficient to fund activities other than staff time
devoted to developing a statewide EMS data collection system.
To fund the hardware, software and contracts necessary to develop
this system, staff of the Section of Emergency Programs must
seek additional funding through grants.
The EMS Program gratefully
acknowledges the funding received from the Alaska Highway Planning
Agency (within the Alaska Department of Public Safety) and the National
Emergency Medical Services for Children Program. Both agencies
funded Emergency Programs grant applications which allow some essential activities
to occur to achieve the goals expressed below.
The Plan:
Phase I: Development
of Central System Resources
The first phase of
the plan includes development of system resources within the Section
of Emergency Programs and includes the following tasks:
- Developing and
publishing an input data set format which contains the essential
NHTSA data elements and can be used by software vendors as a template
for adding export functions to software for use in Alaska.
- Identifying and
purchasing "system" software which can be used to accept
data from a variety of sources (keyboard, internet files and remote
client software) to provide data analysis and reports which can
be used at a local, regional and state level.
- Hosting a two
day forum on data collection which showcases state of the art
EMS data collection software and includes a one day NHTSA EMS
Information Systems (EMSIS) workshop to provide information on
implementation issues, including financial, political, legal and
technological matters, and to assist us in refining our plan of
action.
- Funding technical
experts to present information on data collection and reporting
at EMS symposia.
- Developing sustainable
capabilities within Emergency Programs to accept datafiles and provide meaningful
and timely reports to local EMS agencies.
- Surveying communities
to identify local data needs and capabilities.
- Encouraging emergency
medical services, hospitals and clinics to work together to ensure
that prehospital run reports are made part of the patient's official
hospital record.
Phase II: Development
of System Resources in Key Communities
The second phase
of the plan includes making the system operational (acquiring and
analyzing data and providing reports to local communities) and "priming
the pump" by:
- Facilitating the
development of "data translation" software which can
take the data from data software widely used in Alaska (such as
NFIRS) and convert it into a format useable by the statewide data
reporting software used by Emergency Programs.
- Encouraging larger
EMS systems, which are already collecting electronic data, to
submit the data on a periodic basis to the statewide EMS data
collection program.
- Funding software
and hardware for use by key communities.
- Working with the
Alaska State Fire Marshal's Office to develop a plan for acquiring
EMS data from NFIRS compatible software used by fire service based
EMS agencies.
- Demonstrating
the usefulness of comprehensive and credible prehospital EMS data.
Phase III: Full System
Implementation and Continuation of Local Resource Development
The last phase of
the plan expands the number of services participating in statewide
data collection and reporting activities. Characteristics
of this phase include:
- An increased number
of services submitting data and receiving reports.
- Funding hardware
and software for several more communities.
- More widespread
(local, regional and state) and targeted use of data acquired
through the state EMS data collection system.
- An increased number
of requests for reports and data analyses from the statewide data
collection system from EMS agencies, local and state governments,
and the media.
The Ultimate Goal:
Ideally, every service
will be submitting data on every response to a medical event, and
the analysis of this population based data would be used to develop
and support medical and program policy decisions, as well as funding
issues.
Summary:
This web page has
provided information on the ambitious plans of the Section of Emergency Programs. We believe a comprehensive data system is
essential to ensure the medical appropriateness and financial well-being
of the EMS System in Alaska. Comments on this plan,
both positive and negative, as well as suggestions for improving
the plan are welcome and can be sent to Shelley Owens,
EMS Unit
Manager.
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