1. Emergency Medical Services Data Jay Bradshaw, Director Maine Emergency Medical Services Department of Public Safety

2. Maine EMS EMS patient/run report data system since 1979; standardized and mandatory since 1982 Largest state EMS data repository in US: > 3.7 million records since 1980 ~ 250,000 calls in 2006 Standardized data dictionary – NHTSA essential data elements – NEMSIS

4. How are MEMS data used? System evaluation Quality Improvement Protocol changes (Tx & Rx) Public information & education Legislative information Research

5. Maine EMS Marcolini EG, Burton JH, Baumann MR, Bradshaw JR: A Standing- Order Protocol for Cricothyrotomy in Prehospital Emergency Patients. Prehospital Emergency Care, 2004; 8: 23-28. Burton JH, Baumann MR, Maoz T, Bradshaw JR, Lebrun JE. Endotracheal Intubation in a Rural EMS State: Utilization and Impact of Skills Maintenance Guidelines. Prehospital Emergency Care, 2003; 7:352-356. Pazdral TE, Burton JH, Bradshaw JR. Amiodarone and rural EMS cardiac arrest patients: A cost analysis. Prehospital Emergency Care, 2002; 6:291-295. Burton JH, Dunn MG, Harmon NR, Bradshaw JR. EMS Provider Findings and Interventions with a Statewide EMS Spine Assessment Protocol. Prehospital Emergency Care, 2005.

6. Maine EMS Abstracts: Marcolini EG, Burton JH, Baumann MR, Bradshaw JR: A Standing-Order Protocol for Cricothyrotomy in Prehospital Emergency Patients: Utilization, Indications and Outcomes. 2002 SAEM Assembly Pazdral TE, Burton JH, Bradshaw JR. Amiodarone and Rural EMS Cardiac Arrest Patients. 2001 SAEM Assembly.

7. Paper, Bits, and Bytes Paper, and lots of it – Expensive – Entry “issues” – Timeliness, or not First attempt – RFP – Contract awarded to small company – Lots of interest, but – Lousy technical support Second attempt

9. Plan of Action Survey to all EMS services – 65% responded (185/285) Interviews with – Services (5) – Maine Medical Center (ED, trauma, & research) – Bureau of Health – Fire Marshal – Maine Health Information Center

10. Survey Results The haves (162) – OS primarily Windows – Majority have Internet access – Computer support The have nots (23) – Budget – Size of agency

11. Survey Results Willing to use web-based application? – Yes (77%) – No (23%) Budget / size of agency / Internet access However – they would use one if required to do

12. Plan of Action Educate EMS providers 3 phase plan – Web based application – Client software – Reporting tool w/ data mining

13. Essential to Providers HIPAA Export to billing Import from other programs – Billing & CAD Not require broadband Internet Standard and ad hoc report generating

14. Important to MEMS NEMSIS Include all EMS runs, from all services User friendly Import from other formats Experience with NEMSIS, HIPPA, and EMS systems. EMSSTAR Recommendation

15. MEMSRR RFP ImageTrend Training, training, and more training Partnership with Maine CDC (Bureau of Health) Grants

16. Lessons Learned People who said ‘yes’ at one time do not give up their right to change their mind. Computer proficiency is much less than anticipated Change is bad Change from paper is very bad Staying the course helps more than a fancy brochure

17. Be honest about the learning curve Hospitals in the midst of converting to electronic records may be less-than-enthusiastic about another such change, but with time and attention will become invaluable allies. Neighboring states can help, sometimes Web hosting is a bigger deal than anticipated PDAs are great for grocery lists, but not as great for PCR NEMSIS is only a starting point NICE (National State Enhancement) Codes – PIFT/ATV/Skiing/Moose & Squirrel

18. State of the State 33 services 25,000 records