Preventive Measures

Every year, hundreds of EMS personnel fall ill or die due to job-related illnesses or circumstances. Just how many succumb, where, how often and why, is still somewhat of a mystery. It’s a riddle that has always bothered Geoffrey Miller. 

Miller, who is associate director for research and curriculum development at the Gordon Center for Research and Medical Education at the University of Miami’s Miller School of Medicine, recognized the lack of a centralized and organized national repository of data related to the occupational illnesses, injuries, and deaths of EMS providers throughout the U.S., and he decided to change that.

He has spearheaded the development of the first and only National EMS Health Surveillance System in the country.

The Need for Tracking
Although some statewide systems do exist for reporting deaths to the Occupational Safety & Health Administration (OSHA), perhaps surprisingly, there’s currently no central database where EMS organizations of all system configurations can report specifically on EMS personnel. 

“If you’re a fire department, you can track the types of injuries your employees are sustaining and some of the contributing causes and factors that tie into it. On the EMS side of the house, we don’t have that,” Miller says. “If we are to look after the well-being of the men and women who are providing EMS, regardless of the service-delivery model, we need a system to try to track the causes of these injuries, the human factors that may lead to them, and the deaths that are associated with some of them.”

To begin such a daunting undertaking, Miller approached the board of the International Association of Emergency Medical Service Chiefs (IAEMSC), who wholeheartedly supported the idea. IAEMSC took the idea to
Intermedix, a market leader in revenue-cycle management for EMS. 
Intermedix offered to provide the technical support and build the data-collection tool and Web site needed as foundational support of the program.

“Intermedix also provided the appropriate levels of security we needed,” says Miller. “We have the same type of security you would have with a patient care record.”

The system is currently in the beta-testing phase. Eventually, it will allow EMS organizations across the U.S., as well as other countries, to voluntarily report the occupational illnesses, injuries and deaths of EMS personnel, using a common Web-based tool. By capturing this data, IAEMSC will be able to conduct research and potentially find solutions to reducing the annual number of EMS illnesses and deaths.

“We have four agencies that are participating, and they represent several different delivery models,” Miller says. “There is no state or federal mandate to participate in this type of reporting system. We’re just hoping that people will be interested in it.” 

System Execution
EMS organizations will register for the system through an online registration system; users will be verified. “The system doesn’t track individual-level data, but it does have sensitive information that we want to make sure is maintained in a secure format,” Miller says. “So once an agency registers, their authorized users will be verified with the department head to ensure that these people are who they say they are.”

Organizations will be asked to set up an agency profile. Once the profile is established, they can submit specific information related to on-the-job illnesses, injuries, or deaths. Miller will be the lead researcher analyzing the data and reporting to the EMS community and governmental leaders.

“We’ve done some things to make it user-friendly. It will be all Web-based, and it’s modeled after the law enforcement and fire service injury and data collection systems,” Miller says. “Hopefully we’ll be able to make a lot of correlations throughout public safety as a whole and within our own industry.”

The surveillance system, which is still relatively new, is working well in beta testing. This includes the reported ease of use, which was an important consideration when developing the program. The system is driven in large part by drop-down menus.

“We haven’t experienced any major problems,” says Miller. “There are some pretext entries for things that are outside the normal expected causes, and that’s part of the beta testing. We want to see if there are things popping up with any kind of frequency that we need to add to drop-down lists.”

The drop-down menus were created for ease of use, but Miller also wants the surveillance system to be conventional across agencies. “We are trying not to have to customize the system for every agency, because then it makes it very difficult for us to make correlations or comparisons across regions, states or the nation,” he says.

Getting the Word Out
To advertise the system, IAEMSC will be working with state EMS directors and Intermedix on a marketing plan. “It will be a grassroots campaign, and with these different bodies, we can get the message out to nearly every agency in the U.S. to get them enrolled and tracking information,” says Miller. “It will serve to augment what other agencies and departments are doing to track injuries for personnel.”

Miller sees the surveillance system as a real win-win for EMS. Agencies will enter information that will help build a picture of what’s happening to the men and women of EMS. At the same time, those agencies can generate specific reports to attach to personnel files or other human resources documents produced for an injury or incident.

“We’re trying not to duplicate the amount of paperwork,” Miller says. “We’re trying to augment what they already have and then create a system that will also allow us to track what’s happening at the state, regional and national level.”

Miller acknowledges that there are other databases that track medical information, but they are more focused on patient care and don’t usually include much data on what’s happening to responders. 

“We’re trying to create something fairly synonymous and use a lot of the same language,” he says. “Hopefully one day, all of this information will be integrated into a more comprehensive operational and patient clinical care data-collection system.”

Once the system is fully operational and available–targeted for this spring–it will be at no cost to agencies   wishing to access the system and use the software. 

“We are trying to do this at no cost to encourage the greatest number of users, and fortunately, we have been able to do that because of the gracious work of Intermedix volunteering to pay for the technology and the development of the security,” Miller says. 

“We are hoping that people will get on board and start entering their data, using the system to their advantage, and, more importantly, we are hoping they will take advantage of the reporting we want to also offer.”

A Broad-Based View
Ultimately, Miller hopes the national surveillance system will be just that–a system that will take snapshots of state, regional, and national areas and offer up information concerning trends. 

“The ones we are most concerned with are preventable injury trends, so that we can offer advice back to the community to make safety changes, or make policy changes regarding certain activities, and also help lead the equipment technology industry,” he says.  

Miller would also like to see the information support lobbying and advocating efforts for the health and safety of EMS providers.

“You see stories about ambulance accidents or paramedics assaulted,” he says. “These stories are not collected in any type of main repository that allows us to pull out any meaningful information to turn around to the state and federal governments and say, “˜We have a problem and we need to fix this.'” Miller hopes the gathering of such stories will influence future legislation and fund research for better safety systems and protective equipment for EMS personnel. 

“EMS is a very precious resource and we can’t afford to lose providers to things that we can prevent. We need to start carrying a bigger voice for ourselves, and we won’t be able to do that until we actually have some data that we can turn to to show the trends and activities that are occurring.”

To date, agency interest in the system is growing, with some agencies already announcing plans to participate. Miller couldn’t be more pleased.

“We know through some of the associations that there is pretty keen interest to get it into full distribution,” he says. “It’s good to have that kind of proactive thinking on the part of agencies who are trying to look after the men and women working for them.”

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