Denver EMS bureau shows how health information exchange improves emergency medicine

South Metro Fire Rescue Authority chief to speak at HIMSS16 about role of EMS in the care continuum.
By Mike Miliard
08:21 AM

Linking its emergency medical service teams with Colorado's state health information exchange has made a big difference in how first responders are able to assess, treat and sometimes follow up with patients, according to Richard Lewis, EMS bureau chief of the Denver-area South Metro Fire Rescue Authority.

"We collect all the same information," he said. "We just don't store it the same way."

Now that 18 months have passed since initiating the project, Lewis said bigger effects are on the way.

In his session at HIMSS16, "HIE Applications in Emergency Medical Services Settings," Lewis will talk about how his department sorted through technology and workflow issues to better use HIE in its emergency response — and talk about the cost efficiencies and care improvements it has enabled.

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Too often, the state of data exchange between EMS teams and hospitals is limited. "There's no communication between us and the hospital other than a radio," said Lewis.

What valuable data there is from the emergency encounter, meanwhile, is typically underused, if it’s used at all, he said.

"For all the electronic information we collect, at the very end, we push send and a fax is sent to a portal. Half the hospitals in the Denver metro area print it out and scan it back into their EMR; and both halves bring it back as a .jpg at the back of a medical record that will never be used again."

In joining the network of CORHIO, the Centennial State's HIE, "our whole goal is to make that one continuum of care," said Lewis. "Because as soon as we can push information into that system, we can pull information from it."

Working with CORHIO has been "one of the best experiences I've ever had in my life," said Lewis. "When you sit down and say, 'What if?' they just start adding people to the team and stuff happens. … It has made a world of difference for us."

Overcoming inefficiencies

In the old days, hospital clinicians seemed to feel "that our end of it stopped when we dropped (a patient) in the ER, and theirs started when they picked them up there."

That's changed now and has enabled a much more beneficial back-and-forth between frontline responders and hospital staff.

Before signing on with the HIE, he said, "If we ran 12,000 calls we would probably get follow-up on a little less than 1 to 2 percent on some of them. Now, he said, we can follow up on any one that we want, and we can follow up right then: The second that the person pushes, they're done with their chart, they sign it electronically, and it gets loaded to CORHIO and we can see it.

"It's instantaneous follow-up," said Lewis. "Typically our follow-up before was a digest of their thoughts as they track through the case, and we get it raw and unfiltered now. That makes a big difference."

Arriving at an assisted living or a nursing home and having a person's healthcare record readily available there via HIE is "invaluable," he said.

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The hope is that more and more hospitals and EMS departments will agree.

"The more people that get on board and make that kind of a link normal, then people like me don't have to pay extra for development costs — it just becomes part of the normal products we consume," said Lewis. "If everybody around me did the same thing, my life would be really easy. Eventually, I think they will."

"HIE Applications in Emergency Medical Services Settings” is slated for March 2 from 2:30 to 3:30 p.m. in Lando 4205 at HIMSS16 in the Sands Expo Convention Center in Las Vegas.

Twitter: @MikeMiliardHITN

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(Photo by Sturti/ Getty Images) 

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