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Statewide Trauma Database Nears Start

LITTLE ROCK, Ark. -- A Web site that provides up-to-date status information on Arkansas' 108 hospitals is expected to be operational Nov. 1, providing the first key element for a statewide trauma system, hospital officials said last week.

The Arkansas Department of Health is contracting with Metropolitan Emergency Medical Services, or MEMS, to design and manage the "trauma dashboard," which will give hospital officials a quick way to see where they can transfer patients needing specialized emergency care, said Dr. James Graham, chairman of the Governor's Trauma Advisory Council.

Emergency room personnel currently have to call hospitals individually to find one best able to treat a patient, which can take hours, he said.

"This is a major step forward that's going to help a lot of patients, not just trauma patients," said Graham, division chief of emergency medicine at Arkansas Children's Hospital. "It could save an enormous amount of time." The dashboard is being paid for with $52,000 of the $200,000 Gov. Mike Beebe designated in July to pay for computer hardware and software to collect and store information on the state's emergency medical services.

The money came from the $500,000-a-year Governor's Emergency Fund. It was meant to boost efforts to develop an Arkansas trauma system by providing definitive data to legislators as they consider proposals to establish such a system during the 2009 legislative session, Beebe said at the time.

A trauma can be any sudden injury resulting from an external force, such as a car accident, elec- trocution or gunshot wound.

A trauma system is a statewide communications network that allows emergency personnel to coordinate emergency care to make sure no matter where people are injured, they're able to get medical care as quickly as possible.

"In time-sensitive situations, it's all about getting the right patient to the right place at the right time," Graham said.

Dr. Joe Thompson, the state's surgeon general, has estimated the cost of establishing a trauma system at $28 million to $35 million.

State health officials predict having a trauma system would prevent 200 to 600 deaths and would reduce the 1,200 preventable disabilities in Arkansas each year.

Bo Ryall, executive vice president of the Arkansas Hospital Association, said the dashboard is an initial step that will help reduce the amount of time it takes hospitals to transfer patients to facilities best able to treat them.

"This is needed and wanted to help move patients," Ryall said. "It has statewide impact." In addition to Arkansas hospitals, the state Health Department plans to work with some out-of-state hospitals that regularly treat Arkansas patients to include them in the dashboard, said department spokesman Ed Barham. Renee Mallory, Health Department branch chief of health systems licensing and regulation, said training hospital personnel on the new system will begin over the next few weeks. Once operational, the dashboard will be updated every two minutes, said MEMS director Jon Swanson. Hospital personnel will have to call MEMS to update any status changes.

The Web site will have a color-coded chart to identify hospitals' current capabilities in categories such as general surgery, neurosurgery or orthopedic surgery.

Available services will be marked in green. Hospitals lacking services will be marked in maroon, meaning they never have them, or bright red, meaning they normally have them, but don't at that moment.

Yellow will identify hospital services that are overcapacity, Swanson said.

MEMS will collect data from the dashboard to help hospitals identify status trends.

MEMS developed its own dashboard for its four-county service area last spring. Swanson said the system has helped decrease hospital transfers.

"It improves our ability to get patients to the most appropriate facility the first time," he said. "We're able to make better realtime decisions." While the statewide dashboard will help hospitals speed up inter-hospital transfers, the dashboard's use by EMS personnel is restricted by state laws that require them to take patients to the hospital of the patient's choice within a specified service area, Swanson said.

Those laws would have to change to have an effective trauma system, he said.

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