Why EMS Must Be Part of Health Information Exchanges

The Affordable Care Act (ACA) highlighted a few glaring deficiencies in the U.S. healthcare system, namely around data exchange and information sharing. Following the ACA’s passage, hospitals, doctors, labs, clinics and other traditional healthcare providers scrambled to figure out how the provisions requiring data sharing would be implemented.

Fast-forward to the present. Health information exchanges (HIEs) are all over the country, each trying to stay ahead of the regulations that many are just now beginning to understand. Hospitals are starting to share more information with each other, labs and clinics are participating, and doctors are beginning to have better information with which to treat patients. Despite these efforts, there is a huge piece that is missing from the equation that many people still fail to recognize—ambulance data.

What’s perplexing is that, according to the National EMS Information System (NEMSIS), more than 75% of U.S. states already have an electronic storage system that houses this data—a system conceptualized over 15 years ago. These systems vary across entities, with differing levels of complexity.

Data is derived from local EMS providers contributing information to their respective state healthcare registries (generally managed by Health and Human Services in some form), ultimately to be used for analysis to improve care provided by paramedics and emergency medical technicians on the street. However, despite the maturity of the model and its contribution to better patient outcomes through research and analysis over the long term, short-term issues persist.

EMS agencies must build on this effort and become a more formalized part of the exchange of patient data, not just in the reporting and collection of data. This exchange occurs between emergency departments, physicians and EMS providers in only a few parts of the world (e.g., United Kingdom), but severely lags in most other mature markets, such as the U.S., Australia and Canada, among others. Every local government provides EMS service, whether public, private or volunteer. It’s a core community service that we all depend on when we are at our most vulnerable. As such, every local government is effectively a healthcare provider, similar to a hospital or clinic. So why are EMS providers continually overlooked in the HIE equation? Perhaps it’s because they are the smallest “cost” in the healthcare chain, or maybe because they don’t have the “voice” of hospitals and health insurers?

Considering the positive implications of collaboration throughout the continuum of care, the current state of information sharing is problematic. Data information exchange platforms, like ones used by hospitals across the globe, are not exclusively for hospitals, physicians, labs and clinics. These tools provide an avenue for local governments to connect to HIEs, providing them instant operational and strategic value. Combined with the data that is already being collected, using these tools, EMS providers can:

• Give paramedics real-time access to critical patient information including allergies and serious health conditions before they arrive on scene.
• Equip the new breed of paramedics, sometimes referred to as advanced paramedics or community paramedics, with detailed patient information as they conduct home visits following a patient discharge from the hospital.
• Enable data sharing between EMS agencies during mass casualty events, ensuring patients are provided optimal care during difficult disaster situations.

Ultimately, EMS is healthcare, and EMS agencies can provide tremendous value to the HIE equation because they are often the conduit between spokes in the giant healthcare wheel.

Kurt A. Steward, PhD, is vice president at Infor.