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Wireless and Health IT in Medical Emergencies

Wireless and Health IT in Medical Emergencies. New America Foundation Conference COMCARE Emergency Response Alliance March 23, 2009. Wireless, Health and Emergencies. First impressions: pacemakers crashing Today, the indispensible tool First first responders: 300 million cell users

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Wireless and Health IT in Medical Emergencies

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  1. Wireless and Health IT in Medical Emergencies New America Foundation Conference COMCARE Emergency Response Alliance March 23, 2009

  2. Wireless, Health and Emergencies • First impressions: pacemakers crashing • Today, the indispensible tool • First first responders: 300 million cell users • First first responders: smart devices • First responders: 2 million Americans • Emergency medical response chain: wireless everywhere • Car crashes to heart attacks to disasters • 9-1-1, EMS, fire, EM, police, hospitals COMCARE Emergency Response Alliance

  3. • Crash Time: 04:40 pm • Notification Time: 04:41 pm • Police Response Time: 04:45 pm • EMS Response Time: 04:48 pm • Delta Velocity ( D V): 16 mph • Principal Direction of Force: 2 o’clock • Number Injured: 2 • Maximum AIS: 2 6 X acceleration Z acceleration 4 Y acceleration 2 0 Acceleration -2 -4 -6 -8 -2 -1 0 1 2 3 Time (seconds) Automatic Crash Notification (ACN)ACN Crash - January 31, 1999 Source: Veridian Engineering COMCARE Emergency Response Alliance

  4. Carolinas MED-1 / K Mart General COMCARE Emergency Response Alliance

  5. Secure, accessible patient health records COMCARE Emergency Response Alliance

  6. Emergency Response EHR • HHS/AHIC called for emergency use case • HITSP did it over 2 years • HITSP Interoperability Specification 4 • All hazards emergency medical: disaster/crash • All sources of data: PHR to OnStar • 9-1-1, EMS, emergency management • Amalgam of emergency and health standards • Endorsement of core services: agency registry, rights management • HITSP ISO 4: in Fed Register in January COMCARE Emergency Response Alliance

  7. Integrated Emergency Medical Response: Implementing ER-EHR COMCARE Emergency Response Alliance

  8. Medical Problem Being Addressed • Emergency medical response is a resource limited environment • Patient outcomes are tightly linked to decisions made at the earliest steps in emergency response • Application of best practice guidelines is dependent on accurate data relevant to the specific incidents • Today a wealth of information exists but is out of reach for responders COMCARE Emergency Response Alliance

  9. Incident location Crash data; make/model Hazmat/train/truck contents, instructions Injury prediction tools Personal Health Records Hospital Records Vehicle extrication information Traffic advisories Hospital diversion and bed information Medical expertise availability Just in time training Information Available Electronically COMCARE Emergency Response Alliance

  10. Challenges • Health most backward sector in IT – except for emergency response • How to incent adoption of EHRs? • Show value to public • Deliver key data to emergency responders • Would help solve overall emergency interoperability at same time • It’s the same problem of the commons COMCARE Emergency Response Alliance

  11. Opportunity • Modern information technology enables interop • Treat “safety as an enterprise” • Solutions cutting across domain silos • Netcentricity addresses balkanization; the cloud • Core services + open standards allow enterprise interop; interfaces to legacy systems • There is no single buyer; need to take commercial approach to govt market • Offer hosted services to 1000s of small agencies COMCARE Emergency Response Alliance

  12. Implementing ER-EHR

  13. Who Should Care about ER-EHR? • Leaders in trauma: Mayo, Johns Hopkins, other • Big PHR/EHR platforms: Google, Health Vault • Themselves • Their partners • All EHR vendors • Traditional emergency sources: MedicAlert • Carriers looking to fill pipes: CMRS • Hospital systems • HMOs • CDC: syndromic surveillance COMCARE Emergency Response Alliance

  14. Government’s Role? • Ensure EHR process/funding includes emergencies • Drag 9-1-1, EMS, others to the table • Where are Medicare, Medicaid and AHRQ? • Where are DOD and VA? • Address the key problems of the commons • Accelerate standards, especially across domains • Fund reference models of core services; then support standardizing them • Incent development of hosted, managed services • Fund Total Cost of Ownership studies • Fund field deployments of ER-EHR COMCARE Emergency Response Alliance

  15. Questions and Comments David K. Aylward Director COMCARE Emergency Response Alliance daylward@comcare.org See www.comcare.org/video.html for a short video of our emergency medical vision COMCARE Emergency Response Alliance

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