Prehospital Care Report

1. Proposed Profile: Prehospital Care Report – Integration of Motor Vehicle Crash Victim ECON / PHR Data

• Proposal Editor: Kboone
• Profile Editor: TBD
• Date: N/A (Wiki keeps history)
• Version: N/A (Wiki keeps history)
• Domain: PCC

2. The Problem

There is consensus among the emergency healthcare community that the widespread adoption of Health Information Technology (HIT) by the automotive industry will lead to a faster and more appropriate response. This will lead to safer, more effective health care for crash victims following a motor vehicle crash.

The quid pro quo for investing in such systems is the improvement of safety, care, and outcomes for the nearly 250,000 crash victims (6,000,000 worldwide) who sustain life-threatening injuries annually as a result of motor vehicle crashes.

Persistent deficiencies in the quality of emergency healthcare for motor vehicle crash victims is attributable in part to the continued reliance by many emergency responders and emergency room clinicians on archaic, paper-based methods of communicating crash victim key health information, such as Emergency Contact Information (ECON) and Personal Health Record (PHR) data.

Under a worst-case scenario, an emergency room clinician in an out-of-town emergency room trying to treat an unconscious crash victim would have no idea what other medical conditions the crash victim might have or which medications he or she might be taking, nor contact information for an emergency contact / next-of-kin who might be able to provide such data. This lack of data increases the risks of adverse reactions to treatment or medication that threaten the safety, care, and outcome for crash victims.

Specifically, the current HIT challenge is 1) Emergency Responder real-time access and exchange of crash victim ECON / PHR data at the scene of a motor vehicle crash**, and; 2) Electronic integration of ECON / PHR data into Ambulance Information System (AIS) pre-hospital care reports supporting real-time messaging of crash victim ECON / PHR data to Emergency Department Clinicians. At present, ECON / PHR data obtained by emergency responders prior to arrival at the emergency room is often conveyed as a handwritten paper document or in electronic form after the fact.

• • See Automotive ECON System infrastructure profile proposal in ITI

3. Key Use Case

<Describe a short use case scenario from the user perspective. The use case should demonstrate the integration/workflow problem.>

1. A patient is involved in a car accident.
2. An ambulance is dispatched to the scene.
3. Ambulance personnel treat the patient for trauma and shock, and note signs of internal injuries.
4. Patient is transported to the emergency room at the nearest hospital.
5. Police attempt to notify family members.
6. Upon delivery of the patient to the emergency room, treatment for internal injuries is begun.
7. The patient is identified in the Emergency Department information system.
8. Ambulance personnel complete their run report, and provide a copy to the emergency department.
9. Family members contact the hospital, and try to obtain information about the patient status.
10. At the same time, emergency department personnel are attempting to contact family members to obtain more information about the patient.

<Feel free to add a second use case scenario demonstrating how it “should” work. Try to indicate the people/systems, the tasks they are doing, the information they need, and hopefully where the information should come from.>

1. A patient is involved in a car accident.
2. An ambulance is dispatched to the scene.
   • Electronic information is sent to the Ambulance Information System (AIS) identifying the location of the scene, and the patient identity.
   • The AIS retrieves patient history information from a PHR.
3. Ambulance personnel treat the patient for trauma and shock, and note signs of internal injuries.
   • Treatment details are recorded in the AIS.
4. Patient is transported to the emergency room at the nearest hospital.
   • Transport details are recorded in the AIS.
   • Ambulance Attendant updates treatment details in the AIS.
5. Police attempt to notify family members.
   • See Emergency Contact Registry in ITI, not really relevant to this profile.
6. Upon delivery of the patient to the emergency room, treatment for internal injuries is begun.
   • An electronic record of the treatment is provided upon delivery to the facility.
7. The patient is identified in the Emergency Department information system.
   • Information already provided by the ambulance attendant is used to quickly update the Emergency Department records.
8. Ambulance personnel complete their run report, and provide a copy to the emergency department.
9. Family members contact the hospital, and try to obtain information about the patient status.
   • See Emergency Contact Registry in ITI, not really relevant to this profile.
10. At the same time, emergency department personnel are attempting to contact family members to obtain more information about the patient.
    • See Emergency Contact Registry in ITI, not really relevant to this profile.

4. Standards & Systems

<List existing systems that are/could be involved in the problem/solution.>

• Ambulance Information System
• Emergency Department Information System

<If known, list standards which might be relevant to the solution>

• HL7 CDA Release 2.0
• HL7 Version 2.X ADT
• ASTM/HL7 Continuity of Care Document
• NEMSIS
• VEDS
• LOINC
• HL7 Ambulation Attachment Implementation Guide

5. Discussion

<Include additional discussion or consider a few details which might be useful for the detailed proposal>

<Why IHE would be a good venue to solve the problem and what you think IHE should do to solve it.>

<What might the IHE technical approach be? Existing Actors? New Transactions? Additional Profiles?>

<What are some of the risks or open issues to be addressed?>

<This is the brief proposal. Try to keep it to 1 or at most 2 pages>

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