propriate sharing of clinical information among medical groups, hospitals, clinics, laboratories, pharmacies, and payers (IOM, 2003; SBCCDE, 2006). Approximately 75 percent of the health care providers in the county are involved in the project. There is also an EMS component to the effort. The Santa Barbara County EMS Information Systems Project has sought to develop accurate EMS information systems that are integrated with other health care providers, public safety agencies, and community resources (Santa Barbara County Public Health Department, 2003). This project has the following objectives: (1) to ensure that the times at which calls are received by the PSAP are recorded; (2) to ensure that all providers have synchronized times based on Coordinated Universal Time (UTC); (3) to integrate information from the various providers into a comprehensive EMS response patient care record; and (4) to provide feedback to individual service providers regarding patient outcomes and provider performance. This project meets a number of the goals established by the Emergency Medical Services Agenda for the Future and can serve as a model for other communities across the United States.

Efforts to improve health information technology are aimed at improving the effectiveness, efficiency, and safety of health care interventions. The goal is to link all relevant providers so that communication of vital patient data is smooth, and patient hand-offs are seamless. A key component of that linkage is the hand-off between EMS personnel and hospital-based providers. Therefore, the committee believes there should be improved interface and connectivity between EMS electronic patient records and hospital electronic records, with the goal of transmitting EMS electronic information to EDs in real time.

In addition to patient data, there is often a need for EMS-to-hospital communications regarding the current status of hospital facilities. Ambulance units frequently transport patients to facilities that are on diversion or do not have the necessary subspecialists on call to handle the type of emergency patient they are transporting. Units then must travel to another facility, wasting valuable time in the process. Emerging technology will enable ambulance providers to have ready access to data indicating the current status of hospitals in the local area. Systems in use in Richmond, San Diego, and elsewhere allow ambulance providers to see the diversion status of hospitals throughout the region. This type of information could also assist in detailing recurring diversion patterns at various regional facilities.

SUMMARY OF RECOMMENDATIONS

5.1: States should assume regulatory oversight of the medical aspects of air medical services, including communications, dispatch, and transport protocols.



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