State Keeps Ambulance-Run Data Under Wraps


Jim WoodsMartin Rozenman | | Sunday, September 21, 2008

COLUMBUS, Ohio -- You are far more likely to need an ambulance than a firetruck.

But Ohio won't let you see the records that show how fast the paramedics in your community respond to calls.

Since 2002, the Ohio Emergency Medical Services agency has kept track of response time for each medical emergency in the state. But the agency issues a report card only for each county, not for each fire department.

That's because state lawmakers decided to keep individual departments' records -- not just individual patients' records -- from the public eye.

Fire chiefs say their emergency medical-run times are generally better than their fire-run times because there's less gear to put on and ambulances are smaller and nimbler than fire engines. Medical runs make up 80 percent of the workload in a typical fire department.

Paramedics should strive to arrive within six minutes of an emergency call, same as for a fire call, said Carl Peterson of the National Fire Protection Association.

"With strokes and heart attacks, the first 10 minutes are generally pretty critical."

The Ohio average for reaching a heart-attack patient is six minutes, 12 seconds, the state says. Franklin County averages five minutes, 54 seconds, the best in central Ohio. Licking County is slowest in the region at seven minutes, 42 seconds.

But those are county averages. They don't tell you how fast paramedics in Columbus or Newark will get to you.

The state fire marshal's office does have some incomplete data, said Shane Cartmill, a marshal's spokesman. But a separate state agency keeps the complete medical-run records. State legislators closed those records when they created the Emergency Medical Services Incident Reporting System, which went online in January 2002, said Tim Erskine, chief of trauma systems and research for the Department of Public Safety's Division of EMS.

The system was created by a law enacted in 1992. That law was sponsored by state Sen. Bob Ney, who went on to later infamy as a congressman when he was convicted of accepting gifts from a lobbyist. Erskine said the law overhauled emergency reporting and allowed almost a decade for the system to go online.

Erskine speculates that keeping information on fire departments confidential was probably a way to get them to "buy in" to the system.

Ohio attorney general's opinions have reaffirmed that the names of the fire departments and patients involved in emergency calls are not public records..

The state law preceded the federal privacy law known as HIPAA (Health Insurance Portability and Accountability Act) that limits access to medical records. Under that law, fire departments cannot reveal the names of those they transport.

Dudley Wright, fire chief in Monroe Township in Licking County, sits on the state's incident-reporting advisory committee. He said opening up records about individual departments could help the public see how their paramedics are doing.

"Good decisions are based on solid facts," Wright said. "If the agency is doing the best they can with the resources they have, there is nothing to be ashamed of."

Erskine said he thinks more can be done to analyze the response-time data and that it would be useful to link emergency-run data to hospital records, to chart outcomes.

"We are on the verge of being able to do that," he said. "It will allow us to take EMS records and match them with the hospital data from the Ohio Trauma Registry." The trauma registry is a database of information on severely injured people admitted to hospitals.

Ohio has a federal grant to develop a registry of stroke patients, a project being undertaken by the Ohio Department of Health. Erskine said that agency hopes to match its databases with emergency-squad records.

But unless the law changes, you still won't be allowed to see how well your department does.

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