Emergency departments that have good data connections to emergency medical response data have a leg up on their speed-to-care rates and their ability to improve overall health outcomes.
Likewise, field healthcare clinicians have a vital need for healthcare data exchange.
When EMS agencies access health information through state exchanges, it can improve patient care and their operations, according to a presentation last year at HIMSS24 by the National Emergency Medical Services Information System’s Technical Assistance Center and the University of Michigan’s Center for Health and Research Transformation.
Nationally, the presence of hospital outcome data in the national EMS database improved significantly in 2024, Joshua Legler, an EMS data consultant for NEMSIS, said in an update for Healthcare IT News, which is owned by HIMSS Media.
Data flow to EMS increases
The organization’s technical center encourages EMS organizations to participate in national data networks rather than create point-to-point connections between EMS patient records and a health system’s or hospital’s electronic health records.
Certain EMS agencies have made significant gains in the amount of hospital outcome data they send to the national database as part of their reporting, Legler said.
Looking at the percentage of EMS patient care reports in national and state databases, among all EMS patient care reports where a patient was transported to a hospital – emergency department, inpatient or freestanding ED – he said the increase was significant.
The percentage of records that had data for either the ED Disposition or the Hospital Disposition, with a value other than “Still a patient or Expected to return for outpatient services,” increased to 3.1% in 2024.
While the number of patient care reports NEMSIS shows hospital outcome data for – 1,285,863 out of 34,730,161 hospital transports last year – is preliminary, Legler noted, the amount of hospital outcome data coming back to EMS agencies has increased nearly 3% since 2021.
That year saw patient outcome data on 265,510 patient records, out of 28,641,062 hospital transports, or 0.9%. By 2023, NEMSIS reported an increase in reporting of hospital outcome data to 2.6%
Many ePCR vendors, Zoll, Starwesttech International, Digitech Computer LLC, are receiving hospital outcome data and sending it to state systems, and EMS agencies have made improvements in increasing their data exchange with local hospitals.
Using the National EMS Database data, Legler said one agency in Florida was sending all of its hospital outcome data to the state and then onto the national database.
Another agency in Nevada increased reporting from 4% in 2021 to 69% this year, while a Texas EMS agency increased its reporting to 39% in the same time.
Montgomery County Hospital District, an EMS agency north of Houston, Texas, which has a service area of 600,000 square miles and averages 70,000 calls every year, has been able to get a significant amount of hospital outcomes data back from its healthcare provider partners, said Michael Wells, EMS data analyst at Montgomery County Hospital District based on Conroe, Texas.
“About 80% of our patient transports to a hospital are getting outcome data back,” he told Healthcare IT News in October.
While the degree of interoperability varies by agency, states have also made progress when health information exchanges involve EMS.
“Looking by state, Maine was the biggest mover, as a result of its statewide HIE integration,” increasing from 0 to 13.3%, said Legler.
How patient outcome data improves EMS
EMS agencies say that being able to access patients’ hospital outcomes improves crew morale – which nationally is “stretched beyond the breaking point,” according to a 2023 study led by researchers at Ohio State University College of Medicine – clinician training and employee resiliency.
When hospital outcomes data is returned to EMS, field clinicians can make more informed decisions based on their patient’s medical histories and treatment plans.
With hospital outcome data, EMS agencies can also look at clinicians’ primary impressions and measure them against the emergency department diagnoses, according to Jason Oko, data and preparedness coordinator at Maine Emergency Medical Services.
Oko also points to the ability to better understand patients’ utilization and improve agency financial reimbursements. Ambulance services struggle with successful billing outcomes in their quest to balance costs and revenues.
“As an administrator, after you drop that patient off, we need to make sure that if we bill something, we get reimbursed for it and that the documentation matches,” he said.
EMS clinicians, who are trained on the need to match patient data, can help ensure that the billing process “is fluid,” he said.
Wells said there are four reasons EMS agencies and their healthcare partners should make the effort – starting with field clinician crew morale. For EMS clinicians, a big driver is “getting that emotional closure of what happened to every patient they transport.”
The other three are clinical training and education, payment reimbursements and agency resiliency, which also factors into agency mental health efforts, he noted.
Making the data flow
NEMSIS has been working to align with the Trusted Exchange Framework and Common Agreement with partners interested in improving their interoperability with state EMS systems and building out technical resources for bidirectional exchange.
Last year at the HIMSS24 global conference and exhibition, Legler discussed his work for the NEMSIS EMS interoperability task force and his effort to analyze how interoperability between EMS and the rest of healthcare could be improved and to encourage participation from the “non-EMS side.”
On the EMS side, training staff after patient record systems are set up and ready to receive hospital outcomes data is critical to making the data flow.
“We have a question that says, ‘Were you able to get the hospital number?” Wells explained.
If the EMS provider selects no, and they do not have the number, “they have to write a short explanation of why they couldn’t so that we can follow up on that and try to,” he said.
“If you make the correct way to do something the easy way, then compliance takes care of itself,” Wells said, noting that 80% of Montgomery County’s patient cases are getting valid outcome data from the hospitals.
The remaining 20% have had unknown patient names entered or were brought to hospitals that don’t yet participate in the exchange, he said.
Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.