Upload
piers-gilmore
View
217
Download
0
Tags:
Embed Size (px)
Citation preview
Future of EDXL Standards
www.oasis-open.org
Presented by: Kevin McGinnis, Program Advisor, National Association of State EMS Officials (NASEMSO) & PSG Co-Chair
John Donahue, Chief of Regional Programs and Emergency Operations, Maryland Institute for EMS Systems (MIEMSS)
Jeff Sexton, Tennessee Department of Health, Office of Information Technology Services, Preparedness and Response Systems, HITSP
Dr. Greg Mears, Medical Director & UNC Chapel Hill EMS, HITSP
Capt. F. Christy Music, Program Director, Health & Medical Defense Support of Civil Authorities OASD (HD&ASA), Department of Defense
Timothy Grapes (moderator), VP, Evolution Technologies, OASIS EM TC Voting Member , NIEM EM Domain Support
>> Isn’t proliferation of one-off system interfaces and proprietary solutions just paving over the
cow path? You bet it is. Fact is, there’s no lone system or solution to interoperability.
>>>> You’ll always have your own systems and they’ll be different - requiring data sharing across systems using common protocols.>>>>>> Cross-profession collaboration, open
systems and interfaces, and standards-based exchanges are the easy-to-implement, low-cost solution across local, state and federal
lines. These panelists don’t believe in paving the same old cow path…
Payload routing
The Emergency / Disaster Interoperability Challenge
Responders often cannot talk within their own agencies—let alone other agencies — or across cities, counties, and states. Ineffective communications risk the lives of responders in the field, and for those awaiting help.
There is no one “Silver Bullet” to solve
interoperability challenges.
The interoperability landscape consists of 60,000 state and local public safety agencies, Federal agencies and other stakeholders.
60,000 agencies means 60,000 different sets of procurement regulations, budgets and equipment lifecycles — CANNOT MANDATE
The challenge is to provide ALL stakeholders (Federal, state and local), with the right mix of policies, tools, methodologies and guidance
EDXL Current and Future
You’ve heard about existing OASIS EDXL standards today – Capability exists to support Alerts and warnings, seamless Routing of information, Hospital availability to know where to route patients, and to request, commit, track, status and return Resources.
The DE and CAP standards are available through NIEM adaptors today, followed by the other EDXL standards.
Moving forward, practitioners have prioritized other standards under development. In particular for Situation Reporting about any incident and its response (SitReps - in OASIS), to track patients (TEP), and expansion of TEP to track all victims of any scale incident (TEV).
EDXL-Situation Reporting (SitReps)
EDXL-SitReps standardizes incident operational picture — information about the situation and cross agency/jurisdiction response —
between responders, government officials, coordinating entities and the public.
6
Diagram content courtesy of the Department of Defense, TelemedicDiagram content courtesy of the Department of Defense, Telemedicine & Advanced Technology Research Centerine & Advanced Technology Research Center
Wireless Patient MonitoringWireless Patient Monitoring
Electronic Health RecordElectronic Health Record
Speech RecognitionSpeech RecognitionInputInput
Portable PSCD Type Platform
http://wam.umd.edu/~mvandani/pda/lowfi3.html
MERCY HOSP.
CITY TRAUMA CTR.
LIFE FLIGHT
To MVC
UNITED AMB.
UNITED CCT
United Wheelchair
MVC
CARDIAC
EMSREMS
DOTREMS
RIDGEWAY HOSP.
Specialist Call List
Service Call List
JONES MEM. HOSP. (DIVERT)
RIDGEWAY EMSVERNON FD VOLUNTEER AMBULANCE
MVA
Ridgeway Hospital
MVC
Pt.1
Pt.2
Tib/Fib Fx x1/x1
AO x 4
140/90;88;18;CR+
2ary -; GCS-,TS-
- SOAP Notes
- 3/4 Lead EKG
- 12 Lead EKG
- VS Monitor
10
Incident SiteTreatment Unit
Coordinator Morgue
Priority Red Patients Priority Yellow Patients Priority Green Patients
Transportation Group Supervisor
Transport Unit
StagingDisposition and
Medical Communications
North Hospital
South Hospital
East Hospital
West Hospital
Mass Casualty Branch
Incident SiteTreatment Unit
Coordinator Morgue
Priority Red Patients Priority Yellow Patients Priority Green Patients
Transportation Group Supervisor
Transport Unit
StagingDisposition and
Medical Communications
North Hospital
South Hospital
East Hospital
West Hospital
Garrett
AlleganyWashington
Frederick
Carroll
Howard
Montgomery
PrinceGeorge’s
Queen Anne’s
Kent
Baltimore
Cecil
Harford
Wicomico
Anne Arundel
TalbotCaroline
Dorchester
Somerset
Worcester
Calvert
Charles
St. Mary’s
Baltimore City
JPTAHAvBEDTRAC2ES
TEMARR
Healthcare Beds, Services and Staffing EMS Demographics and Patient Reports Antiviral and Vaccine Distribution Mass Clinic Programs Mass Causality/Victim Management Volunteer Management and Credentialing Alerting and Notification
TEMARRTennessee Emergency Medical,
Awareness, Response and Resources
Systems, Governance, Policies and Technologies
National Activities
Office of the National Coordinator for Health Health Information Technology Standards Panel
(HITSP) Emergency Responder-Electronic Health Record Remote Monitoring
NEMSIS HL7 DHS and FEMA - Grants and Programs
CRI, UASI CDC/HHS - Grants and Programs
Disease Surveillance Situational Reporting
TEMARR
TN TEP and TEV
3 of 5 MSAs Have Patient Tracking Systems Heavy Investment
The rest of TN without
TEMARR
Payload routing
Placeholder: DR. Greg Mears
Brief Overview of NEMSIS 2001 Funded by the National Highway
Traffic Safety Administration NEMSIS is a standardized approach to
EMS patient care data collection and reporting, including: A uniform dataset - Data Dictionary XML Schema to ensure portability of data
NEMSIS
NEMSIS
Need for NEMSIS EMS Education Standards EMS Performance Measures EMS System Evaluation & Outcomes EMS Research EMS Reimbursement Filling Gaps in Electronic Health Record
Version 3 will be HL7 based
NEMSIS
Linkage
MedicalDevice
DomesticTerrorism
Outcomes
QualityManage-
mentPersonnel
System
CardiacArrest
Trauma
Patient
Incident
Dispatch
NHTSA2.0
NEMSIS
www.NEMSIS.org
Local System
State
National
NEMSIS
2424
National General Population Evacuee and Patient Movement, Regulating and
Tracking System
Ms. F. Christy MusicProgram Director, Health and Medical Defense Support of Civil
Authorities Office of the Assistant Secretary of Defense (Homeland
Defense & Americas’ Security Affairs)
October 2009
2525
Create a National General Population Evacuee & Patient Movement, Regulating, Tracking System
Purpose: Build upon existing information systems (military, federal, State, tribal, local, commercial, etc.) and develop a National General Population and Patient Movement, Regulating and Tracking information system that is interoperable and shares data for mass disaster response and optionally, for routine use.
Goal: Federal Sector (DoD, HHS, DHS, FEMA, DOJ, DOT, etc.) provide a national system for all jurisdictions’ use.
Goal: Use a central IT platform or other technology (inter-operability) to share near real-time data among existing systems and support operational functions of tracking, regulating and movement.
Recognized by White House Officials: 2008
Definitions: National, Tracking (Locating), Regulating, Movement
2626
National Initiative History
Proposed by DoD (2004) and requested FEMA (via NDMS) funds
Noted as DHS Priority (2004)
Secretary Ridge’s Homeland Security Interagency Security Planning Effort
Included patient mobilization planning for catastrophic events as a long-term initiative and a high-priority (Reference: Secretary, DHS letter to Secretary, DoD, September 22, 2004).
FEMA / HHS funded; Focus: Tracking recommendations, city-based scenario studies, Mass Evacuation Transportation Model, 2005-2008
AHRQ Project Officer: Dr. Sally Phillips/ DoD Project Officer: Ms. Christy Music
Key Staff: Abt Associates, Mass General Hospital, Brigham and Women’s Hospital
National Advisory Board: HSC, DoD, AHRQ, HHS, DHS, DOT, VA, other federal agencies, State (NY and CA), city (New York, Los Angeles) and private industry representatives
2727
National Initiative History (continued)
Final Report Released by AHRQ: February 24, 2009:
“Recommendations for a National Mass Patient and Evacuee Movement, Regulating, and Tracking System”
Report is located at http://www.ahrq.gov/prep
National Initiative AHRQ Webcast: February 9, 2009
2828
Focus on Multi-Jurisdictional Incidents and Operational Functions
Incident Area
In-State Receiving Areas
Out-of-State Receiving Areas
AirfieldsAirfields
Shelters
HospitalsCasualty Collection
Points
Shelters
Hospitals
Hospitals
IncidentSite
EvacueeGathering
Points
2929
Sample Questions the System Could Answer
The Public: Where is my loved one? I will register to tell my family where I am.
Incident Commanders: How many victims are there? Where are they? Where are more response assets needed?
Emergency Operations Centers: How many patients and general population evacuees exist? Where is there unused capacity? Will I need outside assistance?
Federal Operations Centers: What federal transportation, medical and other assets, will be needed to supplement local and state assets to transport patients and general population evacuees? How many buses or planes are available? How many and what type of special needs general population evacuees, and medical special needs patients, need to be evacuated? Where are the available, staffed and equipped hospital beds with appropriate care for patients?
Emergency Managers: Who exactly is coming on that plane of general population evacuees and/or patients? Who are the attendants? How many service animals/pets are there?
Public Health Department / Relief Organizations: How many people are in shelters and what are their specific needs?
3030
National Mass Patient and Evacuee Movement, Regulating and Tracking Initiative
National Advisory Board Recommendations:
Must build on existing systems (federal, State, local, tribal, private industry)
Must incorporate general population and patient evacueesMust track and give notice of general population members as they become patients
Incorporate data and architectural standards
Maintain HIPPA compliance, as well as other regulatory requirements
Activated system – during major, multi-jurisdictional incident Optional routine use
Begin with local, State and tribal entry, Federal entry last
3131
National Mass Patient and Evacuee Movement, Regulating and Tracking Initiative Recommendations
(continued)
Data from point of injury or first entry into the system, through intermediate locations, through final disposition – location and audit trail
Track location & health status/ needs of any person encountering system
Track at “touch points” (e.g. evacuation centers, overnight facilities, patient collection or staging areas, vehicle loading/unloading, hospitals, shelters, etc.)
Incorporate current or planned Feeder Tracking SystemsJurisdictional, commercial, and agency specific
systems
Incorporate Feeder Institutional Records Systems (“Check-In/Check Out” Systems)
Facilities with mandatory reporting, common software platforms, within an agency (e.g. VA hospitals, DoD Military Treatment Facilities, Indian Health, etc.)
Single facility (nursing home with “homegrown” system)
3232
National Mass Patient and Evacuee Movement, Regulating and Tracking Initiative Recommendations
(continued)Minimum data elements to enter patient/general population evacuee data
Unique identifier (a universal algorithm for assigning IDs would be ideal)
Name, gender, DOB (if not available, substitute age range, race and notable physical characteristics to help identify the person)
Health StatusRed, yellow, or green triage colorICU, floor, or discharge ready/not Acutely ill, well with medical history (needing medical
attention), healthy
Last updated location (ID /name/ type), date, time
Build system to accept more detailed demographic and medical information
Build from person-level data, but accept aggregate (location-level) data
3333
National Mass Patient and Evacuee Movement, Regulating and Tracking Initiative Recommendations
(continued)
Include near real-time regulating and movement data and functions –
Match/ reserve available resources to requirements, release resources, track diverted resources
Example: Reserve ACLS/ATLS ambulance/crew & ICU hospital bed with critical patient
Example: Release bus and shelter beds after general population evacuees have left
System accessible to emergency responders, planners, authorized users
Eventually include public: web- based registration
Free for public, local, State, tribal use – more coordinated, rapid response
Use technology for easy use and interoperability (e.g. scan ID number, web-based, satellite transmission, drivers license, passport, central IT platform, open architecture, etc.), and manual entry
3434
Contact Information: F. Christy Music: [email protected]
703 697-5839
Sally Phillips: [email protected]
301-427-1571