In my role as the EMS Coordinator for St. Elizabeth Healthcare in Northern Kentucky, I’m the interface between EMS agencies in the area and our hospitals. A big part of our mission is to be a community force that’s visible, transparent and achieves superior patient outcomes. But to do that, good data and processes were necessary.
For us, the journey really began in 2015, when we started researching the best ways to get access to prehospital data from our EMS agency partners and bring that data into the ED. We felt that closer collaboration with EMS would provide much better services for the patients in our community, so we made an investment in a technology platform provided by ESO to help facilitate the sharing of data and information. Interestingly, it also helped us address a few other issues, including making the documentation process easier, providing us with measurable insights that we could actually act upon, and even helped decrease staff fatigue.
We have five hospitals and receive patients from 35 EMS agencies, resulting in about 35,000 transports a year. The high volume of EMS runs each day left our hospital staff constantly chasing down documents, billing information and other data necessary to meet reporting requirements, which led to frustration and fatigue.
As a matter of fact, our health information management department had mountains of paperwork, and they were often leaving work early from migraines as a result of spending hours looking up details on screens.
We also noted run recovery rates weren’t as high as we wanted them to be. We were operating on a fax-print-scan-store basis and were only recovering about 60% of runs.
For this to work, it was necessary for all parties involved to buy in to the project. For me, I started with the outcomes and worked backwards from there, to ensure all concerns were being addressed and all potential stumbling blocks were identified, because getting staff acceptance was critical. Otherwise, we wouldn’t use the technology and wouldn’t be able to collect the data and garner the insights necessary to improve patient outcomes.
As we began the work of helping our internal audience understand the value, hospital administrators appreciated how the data and insights would help from a Joint Commission standpoint and EMS was interested in how they could review outcomes and improve quality assurance (QA).
We started seeing results immediately. On day one, we had 98% compliance with CSN capture. Much of that can be attributed to advance awareness and training. Frankly, it was fairly seamless, because capturing the right data had been hardwired into the process.
Collecting the appropriate data quickly has also seen fatigue lessen among staff. The technology made everyone’s lives a whole lot easier. Our medical records team is no longer leaving early to deal with migraines from staring at a computer all day, EMS is excited about what they’re getting and, of course, they want more data. As a matter of fact, we’ve had agencies tailor their 2018 training based on what the data they’ve seen. Their processes and training are becoming more relevant and evidenced-based as they compile new outcomes. It’s great because we’re collaborating with EMS like never before.
There were three main lessons we learned during the entire process that we think are valuable to organizations:
1. Buy-In Is Essential
When you’re implementing a new system, you need to ensure that you’ve got buy-in from everyone in advance. For us, we made sure we had everyone from technical support to field paramedics in the room to talk about the benefits of health data exchange (HDE) across teams. By creating the buy-in early on, the rollout was much smoother because everyone understood their role and what they gained from HDE.
2. Decide on the Right Data
Data sharing is essential for outcome improvement and stronger care delivery systems. However, deciding on the “right” data to share between multiple organizations takes time and planning. I would recommend creating a shared data dictionary so that the exchanged data elements are clinically relevant and can be utilized for improving care.
3. Leverage Analytics for Evidence-Based Practice
Receiving and exchanging data are only part of the solution. You also need to take those data points and translate them into evidence-based practices to really see the full benefit of HDE. We’re looking at changing protocols based on the data we’ve received and analyzed.
Next steps for us include getting lab values and narration in the outcomes report. We think that every hospital in the country should consider this technology platform to leverage innovation and evidence-based practices to serve their patients and community better.