Health Information Exchange
Connecting EMS to the broader health care system through health information exchange is essential and it is inevitable. Access to information leads to better patient care, more efficient transitions of care, improved outcomes and experiences, and stronger disaster resilience.
The U.S. Department of Health and Human Services defines Health Information Exchange (HIE) as "electronic movement of health-related information among organizations according to nationally recognized standards." The goal of HIE programs is to facilitate secure access to clinical data to provide safe, efficient, effective, equitable, patient-centered care. Health information exchange relies on a bi-directional flow of data covering all aspects of the patient care continuum including dispatch, field care, transport, emergency department, hospital admission, hospital discharge, and practitioner care.
EMS is an integral part of the health care system - actions taken by EMS providers at the scene and enroute to the hospital affect outcomes, quality of care and patient satisfaction. HIE allows providers in the field to appropriately access and securely share a patient’s vital medical information electronically.
Currently, few EMS systems are connected to a health information exchange or other electronic health/medical records system. There are many challenges to sharing of EMS data, including funding, proprietary systems, and a lack of collaboration. EMSA is working to overcome those challenges and support providers, health information organizations, vendors, and local EMS agencies in creating the infrastructure necessary for secure two-way exchange between EMS and other health care providers, facilities and payers.
It’s our expectation that EMS will become a full participant in the electronic exchange of health information in the near term with the capability to:
- Search a patient's health record for problems, medications, allergies, and end of life decisions to enhance clinical decision making in the field
- Alert the receiving hospital about the patient's status directly onto a dashboard in the emergency department to provide decision support
- File the emergency medical services patient care report data directly into the patient's electronic health record for a better longitudinal patient record
- Reconcile the electronic health record information including diagnoses and disposition back into the EMS patient care report for use in improving the EMS system
EMS in HIE Knowldge Bank
EMS Patient Care Reports ARE Health Records - Kevin Horahan, J.D., M.P.H., NRP, Senior Policy Analyst, Office of Policy and Planning, HHS ASPR and Rachel Abbey, M.P.H., Program Analyst, Office of State and Community Programs, HHS ONC
Integrating Emergency Medical Services into Health Information Exchanges - HHS ASPR Emergency Care Coordination Center
HHS IdeaLab EMS to HIE Innovation - This project will test the viability of piloting of a single sign-on HIE system in California for providers, including EMS, who serve patients outside of the disaster area.
CA EMS Lumetra HIE Readiness Assessment/Survey - EMSA contracted with Lumetra Healthcare Solutions to determine the initial baseline of health information exchange progress for each of the Local EMS Agencies in California. Brief Summary (Report)
Articles of Interest
"Health Technology and EMS: ASPR Launches Campaign to Improve Pre-Hospital Care." In March 2013 a meeting to address the lack of EMS participation in HIE was hosted by the Office of the National Coordinator for Health Information Technology, an office within the U.S. Health and Human Services Agency. "
EMSA HIE Summit Archives
HIE Bootcamp Presentations
- HIE 101: Foundation and Current State of HIE - Dr. Robert Cothren, California Association of Health Information Exchanges
- HIE 102: Governance and Stakeholder Engagement - Dr. Richard Swafford, Inland Empire Health Information Exchange
- HIE 103: Privacy and Security - Cassie McTaggart, California Office of Health Information Integrity
- HIE 104: Technology - A Deeper Dive - David Minch, HealthShare Bay Area
- HIE 105: HIE Considerations in Designing EMS System Infrastructure - Dan Smiley, EMSA Chief Deputy Director
2014 EMSA Health Information Exchange Summit Presentations
- Maintaining the Momentum - Lee Stevens, Office of the National Coordinator
- Moving NEMSIS into HIE Environments - Dr. N. Clay Mann, University of Utah, NEMSIS
- The California Report: HIE Architecture and PULSE - Scott Afzal, Audacious Inquiry
- NHTSA Vision for EMS and Health Information Exchange - Susan McHenry, NHTSA
- HIE in EMS: Why is it Important? - Nick Nudell, PrioriHealth Partners
- Interconnecting Hospitals with EMS - BJ Bartleson & Lois Richardson, California Hospital Association
- EMS, HIEs, and Health System Resilience - Kevin Horahan, Assistant Secretary for Preparedness and Response
- LEMSA HIE Update - Tom Lynch, Inland Counties EMS Agency
- San Diego HIE - EMS Integration 2.0 - Dan Chavez, San Diego Health Connect
- CAHIE: Health Information Organization's Role in EMS Information Exchange - David Minch, HealthShare Bay Area and Dr. Robert Cothren, California Association of Health Information Exchanges
- Designing a System - Laurent Repass, Orange County EMS Agency and Paul Budilo, OCPRHIO
- Exercise in Health Information Exchange Development - Dan Smiley, EMSA Chief Deputy Director