Welcome to part two of a three-part series focusing on healthcare reform and the future of Emergency Medical Services (EMS). Last month, we reviewed the key concepts of healthcare reform, including the Triple Aim. This month we will focus specifically on Health Information Exchange (HIE) and 4 key EMS use cases where HIE directly impacts operational and patient outcomes. I will also touch on a new state Medicaid funding opportunity for EMS and HIE. Next month, we will finish up this series with a vision of the future.
Healthcare reform will bring significant and meaningful improvements to EMS. To achieve the Triple Aim of improved patient satisfaction (experience and outcome), improved population health (public health and prevention), all while controlling/decreasing cost, EMS must integrate with the healthcare system. Traditional EMS will be a key decision maker for each healthcare system’s success. Since each community typically has 2 or more healthcare systems (hospitals and outpatient systems), it is critical to make sure each patient stays within their healthcare system, to assure continuity, efficiency, and positive outcomes. Through effective EMS patient navigation, the patient not only lands in the correct healthcare system but also enters it through the most appropriate way. Less than one-third of EMS transports require the Emergency Department. EMS treatment and referral to a clinic (at a later date) or transportation to an alternative destination (clinic) will be normal in future.
For EMS to successfully make the correct patient navigation, on-scene treatment, and destination decisions, timely access to the patient’s medical information is critical. Health Information Exchange allows healthcare professionals and patients to appropriately access and securely share a patient’s vital medical information electronically.
The Office of the National Coordinator for Health Information Technology (ONC) has established requirements for the exchange of electronic health records. This is often referred to as Search, Alert, File, and Reconcile. From an EMS perspective, these terms can be defined as follows:
Hospitals and physician’s offices have received federal funding over the past several years to implement EHR systems. Currently, over 98% of Hospitals have EHRs and over 80% are exchanging health information with outside providers.
EMS unfortunately was left out of these original funding initiatives and EMS data systems are now working to build the full Search, Alert, File, and Reconcile capability. Recently a Federal/State (90%/10%) Medicaid Match funding opportunity was introduced to EMS. Funding through this program is available until 2021. It’s focus in on implementing health information exchange and interoperability. The program is managed through each state’s Medicaid office but not all states are participating. The map below outlines each states current participation status. Even if your state is not listed as a participant, please contact your state’s Medicaid office, as their status may have changed. This is a great funding opportunity for EMS.
Next month, we will explore how healthcare reform, the Triple Aim, and HIE ultimately will change EMS forever. Data, along with the devices that collect and analyze it, were once tools in our tool belt used as needed in the provision of patient care. Data and devices now are much more than that...they are a member of our healthcare team. They provide information, guidance, insight, and a level of intelligence directly connected to positive outcomes.