amPHI™ - ambulance record-keeping system John Gade a , Michael Dahl b , Per Thorgaard b , Flemming Knudsen b a Judex A/S, Aalborg, Denmark - PowerPoint PPT Presentation

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amPHI™ - ambulance record-keeping system John Gade a , Michael Dahl b , Per Thorgaard b , Flemming Knudsen b a Judex A/S, Aalborg, Denmark b Sector of Anaesthesia, Northern Jutland, Aalborg, Denmark. Northern Jutland county. 43 standard ambulances: 15.000 emergency turn-outs per year

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amPHI™ - ambulance record-keeping system John Gade a , Michael Dahl b , Per Thorgaard b , Flemming Knudsen b a Judex A/S, Aalborg, Denmark

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amPHI™ - ambulance record-keeping system

John Gade a, Michael Dahl b, Per Thorgaard b, Flemming Knudsen b

a Judex A/S, Aalborg, Denmark

b Sector of Anaesthesia, Northern Jutland, Aalborg, Denmark


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Northern Jutland county

43 standard ambulances: 15.000 emergency turn-outs per year

Special baby ambulance:100 transfers per year (neonates and babies)

Special trauma ambulance:800 transfers per year (adults)


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Increasing duration of transports.

Increasing number of inter-hospital transfers.

Need for pre- and inter-hospital “EHCR”

Future health care

Many small emergency units are closed down.

Centralizing medical treatment (re. DANAMI-2).

and

Increasing demands for collaboration between ambulances, pre-hospital care and hospitals.

Increasing demands for documentation and quality assurance.


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amPHI™ functionality

  • At the site of accident and in the ambulance:

    • Continuous registration of patient data.

    • Quality assurance of the registration.

    • Access to information from IT-systems at the hospital.

    • Guidance of the paramedic team.

    • Access to emergency doctors at the hospital.

  • At the hospital:

    • On-line access to the ambulance record.

    • Booking of tests and clinical experts.

    • Structured communication between paramedics and hospital.

  • Structured documentation:

    • Data for research, education, etc..


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The Alarm

Emergency - dial 112

Alarm112

Alarm central

(Police)

EVA2000

Dispatch central

(Ambulance service)


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Equipment and communication

HospitalIT-systems

Site of accident

In the ambulance

Bluetooth

amPHI™database

XML

WLAN

GPRS

MPLS

EVA2000

(Falck)

Alarm

Hospital intranet


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Integration with the hospitals IT-systems

Access to ”critical medical information”:

Demographic data

Allergies

Chronic diseases

Previous contacts (incl. diagnoses)

More knowledge Þ Better treatment


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Updated patient status

The ambulance service prepares the hospital !

The hospital supports the ambulance service !


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Electronic ambulance record

Divided into logical sections according to the existing paper-based record (Falck) and other supportive sheets:

Treatment

Medicine

Observations

Glasgow Coma Score

Trauma evaluation

Notes

Transport

Patient data

Previous diseases

Treatment before arrival

Status on arrival

Wounds


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Electronic ambulance record

Evaluation of the patient status in the ambulance.... :


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Electronic ambulance record

.... and at the site of accident:


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Hospital intranet

On-line access to the ambulance record:


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Pilot projects

Since the beginning of 2004 amPHI™ has been used in one emergency ambulance (amPHI™ Emergency) and in the special baby ambulance (amPHI™ Transfer).

Printers are installed at 5 gates at 3 hospitals in North Jutland county for printing of the ambulance case report.

The ambulance crew was given a short introduction to the system and was told to use amPHI™ for all patients admitted to one of the 3 hospitals.

Data from amPHI™ Emergency for 1 year was analyzed.


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Results

amPHI™ Emergency:

486 high-priority turn-outs to hospitals with printers.

amPHI™ was used in 377 turn-outs (78%). In Q3+4: 210 turn-outs of (82%).

In 143 cases (38%) the patient ID was sent from Alarm112.In 210 cases (56%) the patient ID was entered by the crew. 24 patients (6%) were not identified.

318 patients (82%) had previous hospitalizations in the county.

Critical medical information was available for 35 patients (9%).


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Conclusions

amPHI™ Emergency:

  • The ambulance crew is satisfied with the system and do not want to revert to the paper charts.

  • The access to the patient’s medical record is very helpful in the emergency cases. The ambulance crew uses amPHI™ to get patient information for most patients admitted to other hospitals.

  • There is still areas where the coverage of the GSM network is insufficient for data communication.


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